Individual
COREY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5501 OLD YORK RD FL LIFTER1, PHILADELPHIA, PA 19141-3018
(215) 456-7405
(215) 456-4703
Mailing address
101 E OLNEY AVE STE 400, PHILADELPHIA, PA 19120-2470
(215) 456-1825
(215) 456-5926
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD482464
PA
207V00000X
Obstetrics & Gynecology Physician
MT217838
PA
Other
Enumeration date
07/03/2019
Last updated
10/03/2023
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