Johnson, Bruce E

Johnson, Bruce E is an individual health care provider with primary practice located at 3 Riverside Cir , Roanoke VA 24016-4955. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Johnson, Bruce E can be contacted via phone (540) 224-5170.

Contact Information

Primary practice address
3 Riverside Cir Roanoke VA 24016-4955
Phone: (540) 224-5170
Fax: (540) 983-8229
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 200400524 North Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 0101243335 Virginia

Profile Details

NPI number 1376535872
LBN Legal business name Johnson, Bruce E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2005
Last updated Dec 12th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376535872 NPPES
North Carolina MEDICAID 891369G
North Carolina Other P00153978
North Carolina Other 1369G

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