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General NPI Number Information
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NPI Number | 1205331899
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Entity Type | Individual
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Provider Name | BENJAMIN ROBERT JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 03/27/2018
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 5900 SIX FORKS RD STE 200
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City | RALEIGH
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State | NC
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Zip | 27609-8226
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Country | US
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Telephone | 919-876-4327
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Fax |
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Provider Business Mailing Address
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Address Line | 5900 SIX FORKS RD STE 200
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City | RALEIGH
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State | NC
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Zip | 27609-8226
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Country | US
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Telephone | 919-876-4327
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Fax | 919-876-6800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0901X
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Taxonomy Name | Otology & Neurotology Physician
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License Number | 202500997
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License Number State | NC
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