Individual
MR. JAMES R JOHANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
708 MCBRAYER HOMESTEAD RD, SHELBY, NC 28152-9532
(704) 484-8123
(704) 434-7262
Mailing address
PO BOX 778, BOILING SPRINGS, NC 28017-0778
(704) 434-8123
(704) 434-7262
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9600957
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46700
NCBCBS
NC
05
—
8946700
—
NC
Enumeration date
07/05/2005
Last updated
07/08/2007
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