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Individual
DIANA E. JOHANSON
Active
Individual
DIANA E. JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
216773
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000026863
BMC
MA
05
—
0189651
—
MA
01
—
04-2817581
UNICARE/GIC
MA
01
—
216773
CONNECITCARE
MA
01
—
33435
HEALTH NEW ENGLAND
MA
01
—
3410756
AETNA
MA
01
—
467270
TUFTS
MA
01
—
5306427001
CIGNA
MA
01
—
AA2007
HARVARD PILGRIM
MA
01
—
J26513
BCBSMA
MA
Enumeration date
12/29/2005
Last updated
03/15/2012
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