Individual
GREGORY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(215) 590-1858
(215) 590-1415
Mailing address
1726 PINE ST, APT 2R, PHILADELPHIA, PA 19103-6780
(248) 767-3734
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD455466
PA
207LP3000X
Pediatric Anesthesiology Physician
Primary
MD455466
PA
Other
Enumeration date
05/18/2011
Last updated
05/31/2023
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