Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD046828L | PA |
NPI | 1063519890 |
---|---|
Provider Name | Cheryl A Johnson |
First Address | West Chester, PA 19380 |
Second Address | West Chester, PA 19380 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 31/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012801970004 | (05) | PA |
F24345 | (02) |