Individual
MRS. CYNDA ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD MBA
Contact information
Practice address
600 MOYE BLVD, FAMILY PRACTICE CENTER, GREENVILLE, NC 27834-4300
(252) 744-4611
(252) 744-4614
Mailing address
2200 SOUTH CHARLES BLVD, GREENVILLE CENTRE ROOM 1515, GREENVILLE, NC 27858-4353
(252) 328-9478
(252) 328-2769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200400689
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
200400689
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1375N
BCBS NC
NC
05
—
891375N
—
NC
Enumeration date
09/08/2005
Last updated
05/30/2008
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