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Individual

STEPHEN E. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6602 KNIGHTDALE BLVD, SUITE 102, KNIGHTDALE, NC 27545-6525
(919) 747-5210
(919) 747-5211
Mailing address
6602 KNIGHTDALE BLVD, SUITE 102, KNIGHTDALE, NC 27545-6525
(919) 747-5210
(919) 747-5211

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21409
NC
207P00000X
Emergency Medicine Physician
42431
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
45904324
CO
Enumeration date
11/25/2005
Last updated
02/04/2014
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