Provider Demographics
NPI:1114219367
Name:JOHNSON, MARGARET OLGA (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:OLGA
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:THE PRESTON ROBERT TISCH BRAIN CENTER AT
Mailing Address - Street 2:047 BAKER HOUSE, TRENT DRIVE
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-4206
Mailing Address - Country:US
Mailing Address - Phone:919-684-5301
Mailing Address - Fax:
Practice Address - Street 1:THE PRESTON ROBERT TISCH BRAIN CENTER AT
Practice Address - Street 2:047 BAKER HOUSE, TRENT DRIVE
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4206
Practice Address - Country:US
Practice Address - Phone:919-684-5301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-016162084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology