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 3 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