| Dr Shawn Paul Johnson, DO | |
|
75 Emerson Bay Rd Ste 102, Carolina Shores, NC 28467-2498 | |
| (910) 579-8363 | |
| (910) 579-8306 |
| Full Name | Dr Shawn Paul Johnson |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Location | 75 Emerson Bay Rd Ste 102, Carolina Shores, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841651312 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 2017-01698 (North Carolina) | Primary |
| Entity Name | Wake Forest University Health Sciences |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003803032 PECOS PAC ID: 4486564952 Enrollment ID: O20031105000436 |
| Entity Name | Novant Health Medical Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366409492 PECOS PAC ID: 1153234893 Enrollment ID: O20031121000692 |
| Entity Name | Theoria Medical |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609362375 PECOS PAC ID: 5395098339 Enrollment ID: O20210429000604 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Shawn Paul Johnson, DO Po Box 60447, Charlotte, NC 28260-0447 Ph: () - | Dr Shawn Paul Johnson, DO 75 Emerson Bay Rd Ste 102, Carolina Shores, NC 28467-2498 Ph: (910) 579-8363 |
Paul C. Whitesides Jr., M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 75 Emerson Bay Rd, Suite 102, Carolina Shores, NC 28467 Phone: 910-579-8363 Fax: 910-579-8306 | |
Maria Rivell, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 75 Emerson Bay Rd Ste 102, Carolina Shores, NC 28467 Phone: 910-579-8363 Fax: 910-579-8306 |