Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2005-01144 | NC |
NPI | 1043223977 |
---|---|
Provider Name | Dr. Ernest F Johnson III |
First Address | Charlotte, NC 28204-3053 |
Second Address | Concord, NC 28025-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2006 |
Last Update Date | 12/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
14057 | BCBS (01) | NC |
5902844 | (05) | NC |
7710564 | CIGNA (01) | NC |
807116 | PARTNERS MEDICARE (01) | |
I14497 | (02) | NC |
P00326285 | RR MEDICARE (01) |