Individual ProviderSandra S JohnsonInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4001 Coliseum Dr, Ste 300-310, Hampton, VA 23666-6257(757) 827-2025PECOS EnrollmentBased on the most recent information from CMS, provider Sandra S Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 33 days ago.Profile DetailsProvider ID1124093166Provider TypeIndividualFull NameJohnson, Sandra STitleDr.CredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date2/22/2006Last Updated1/10/2012Contact InformationPractice LocationPractice Address4001 Coliseum Dr, Ste 300-310, Hampton, VA 23666-6257Phone(757) 827-2025Fax(757) 275-9802Mailing LocationMailing Address4001 Coliseum Dr, Ste 300-310, Hampton, VA 23666-6257Phone(757) 827-2025Fax(757) 275-9802Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense0101043162VirginiaProvider IdentifiersIDDescriptionIssuerID006031919DescriptionMedicaidIssuerUnlistedVirginia