Doctor Name: | DR. PAUL DAVID JOHNSTONE |
NPI Number: | 1912983768 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | 0102050125 |
Business Practice Address: | 1605 General Booth Blvd Virginia Beach, VA - 234545691 |
Business Phone Number: | 7577210512 |
Business Fax Number: | 7577210984 |
Mailing Address: | Po Box 758963, BALTIMORE |
State: | MD |
Postal Code: | 212758963 |
Phone Number: | 8049685700 |
Fax Number: | 8042177991 |
NPI Enumeration Date: | 12/22/2005 |
NPI Last Update Date: | 10/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 0102050125 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |