Basic Information
| Provider Information | |||||||||
| NPI: | 1871884270 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | COLIN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF UROLOGY | ||||||||
| Address2: | 2113 PHYSICIANS OFFICE BLDG. CB 7235 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199662574 | ||||||||
| FaxNumber: | 9199660098 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF UROLOGY | ||||||||
| Address2: | 2113 PHYSICIANS OFFICE BLDG. CB 7235 | ||||||||
| City: | CHAPEL HILL | ||||||||
| State: | NC | ||||||||
| PostalCode: | 275990001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9199662574 | ||||||||
| FaxNumber: | 9199660098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2011 | ||||||||
| LastUpdateDate: | 03/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | 2019-02113 | NC | Y | Allopathic & Osteopathic Physicians | Urology |
No ID Information.