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Individual
DR. NICOLAS JOHNSON
Active
Individual
DR. NICOLAS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
192528
OR
207QG0300X
Geriatric Medicine (Family Medicine) Physician
192528
OR
Other
Enumeration date
06/30/2015
Last updated
01/22/2020
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