Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | MD447608 | PA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | MD447608 | PA |
N | 207RI0011X | Interventional Cardiology | MD447608 | PA |
NPI | 1104995240 |
---|---|
Provider Name | Anthony G Johnson |
First Address | Chambersburg, PA 17201-4232 |
Second Address | Chambersburg, PA 17201-1035 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2006 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1027845010001 | (05) | PA |
270264 | MEDICARE (01) | PA |
F18009 | (02) | MA |