Individual
ISAIAH MICAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
102 HIGHLAND AVE SE, SUITE 303, ROANOKE, VA 24013-2256
(540) 985-9715
(540) 985-9890
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713
(540) 224-5353
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101245336
VA
207V00000X
Obstetrics & Gynecology Physician
30001
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20064957
SELECT HEALTH
SC
Enumeration date
11/30/2006
Last updated
10/28/2024
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