Individual
DR. MARY H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16000 JOHNSTON MEMORIAL DR, 4TH FLOOR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Mailing address
16000 JOHNSTON MEMORIAL DR, 4TH FLOOR, ABINGDON, VA 24211-7664
(276) 258-4050
(276) 258-4056
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
27331
TN
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
9401227
NC
208000000X
Pediatrics Physician
Primary
0101052591
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801896022
—
VA
01
—
46440
BCBS
NC
05
—
8946440
—
NC
01
—
NPI
MEDCOST
NC
05
—
Q015237
—
TN
Enumeration date
07/29/2005
Last updated
02/10/2017
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