Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 20199 | SC |
NPI | 1013907260 |
---|---|
Provider Name | Reid F Johnstone |
First Address | Skyland, NC 28776-2145 |
Second Address | Greenville, SC 29615-4800 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2005 |
Last Update Date | 16/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201999 | (05) | SC |
49251 | PARTNERS (01) | SC |
G69242 | UNICARE (01) | SC |
G692426910 | MEDICARE PTAN (01) | SC |