| Doctor Name: | DR. BRYAN MANEES JOHNSON |
| NPI Number: | 1356590855 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | D0067243 |
| Business Practice Address: | Hhc 3 82 Gsab Fort Bragg, NC - 283100001 |
| Business Phone Number: | 9073968596 |
| Business Fax Number: | |
| Mailing Address: | Hhc 3 82 Gsab, FORT BRAGG |
| State: | NC |
| Postal Code: | 283100001 |
| Phone Number: | 9073968596 |
| Fax Number: | |
| NPI Enumeration Date: | 09/09/2008 |
| NPI Last Update Date: | 09/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | D0067243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |