Johnson, Edward Alex

Johnson, Edward Alex is an individual health care provider with primary practice located at 811 Redgate Ave , Norfolk VA 23507-1515. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Johnson, Edward Alex can be contacted via phone (757) 668-7007.

Contact Information

Primary practice address
811 Redgate Ave Norfolk VA 23507-1515
Phone: (757) 668-7007
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101249802 Virginia

Profile Details

NPI number 1902079015
LBN Legal business name Johnson, Edward Alex
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2008
Last updated Feb 19th, 2019 - about 7 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 1902079015 NPPES
North Carolina Other 186RL BCBS NC
North Carolina MEDICAID 315974 BCBS NC
North Carolina MEDICAID 1902079015 BCBS NC

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