Individual
DR. MICHAEL JAMES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
8811 BLAKENEY PROFESSIONAL DR., SUITE 100, CHARLOTTE, NC 28277-6599
(704) 926-3937
(704) 926-3938
Mailing address
8811 BLAKENEY PROFESSIONAL DR., SUITE 100, CHARLOTTE, NC 28277-6599
(704) 926-3937
(704) 926-3938
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1458
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1234N
BC/BS NC
—
01
—
4105287
MAMSI
—
01
—
5131920001
MEDICARE NFC
NC
01
—
5399513
AETNA
—
05
—
891234N
—
NC
01
—
D6432
MEDCOST
—
Enumeration date
09/26/2006
Last updated
10/26/2010
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