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Individual
DR. BRUCE SAMUEL JOHNSTON
Active
Individual
DR. BRUCE SAMUEL JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8390
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080172913
RAILROAD MEDICARE
SC
01
—
576000003
TAX ID
SC
05
—
RHC210
—
SC
Enumeration date
07/26/2005
Last updated
03/07/2023
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