Individual
SUSANNAH E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2604 DR MARTIN LUTHER KING JR BLVD, NEW BERN, NC 28562-4238
(252) 638-4023
(252) 633-2833
Mailing address
PO BOX 68, POLLOCKSVILLE, NC 28573-0068
(252) 638-4023
(252) 633-2833
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2021-01038
NC
207R00000X
Internal Medicine Physician
50503
TN
208M00000X
Hospitalist Physician
50503
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6002116
BLUECROSS BLUESHIELD
TN
01
—
6010882
BLUE CROSS-BLUE SHIELD
TN
05
—
7100265170
—
KY
05
—
Q001805
—
TN
Enumeration date
03/30/2010
Last updated
07/13/2021
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