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Individual
AMANDA MARIE JOHNSON
Active
Individual
AMANDA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
58104
MN
207RG0100X
Gastroenterology Physician
Primary
58104
MN
Other
Enumeration date
08/03/2012
Last updated
10/29/2020
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