MR. Shannon Patrick Johnson, IDC

NPI #1164635520 in Norfolk, Virginia

Provider Information

NPI Number
1164635520
Entity Type
Individual
Name
MR. Shannon Patrick Johnson, IDC
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Military Health Care Provider - Independent Duty Corpsman
Credential
IDC
Enumeration Date
May 8, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
1004 HERMITAGE RD
Address 2
BLDG 2052
ZIP Code
23521-5000
Phone
(757) 462-3178

Specialties & Taxonomy Codes

Specialty
Military Health Care Provider - Independent Duty CorpsmanIndependent Duty Corpsman

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