Provider Demographics
NPI:1326047549
Name:JOHNSON, VANESSA MP (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:MP
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10 SEARLE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-3035
Mailing Address - Country:US
Mailing Address - Phone:919-681-6006
Mailing Address - Fax:919-684-0745
Practice Address - Street 1:2301 ERWIN RD FL 9
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-4699
Practice Address - Country:US
Practice Address - Phone:919-681-9341
Practice Address - Fax:919-681-7700
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2025-02816207RH0003X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001416735Medicaid
H17576Medicare UPIN
830000128Medicare ID - Type Unspecified