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Individual
DR. TAD MARK JOHNSON
Active
Individual
DR. TAD MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
25307
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659339919
BCBSWI
WI
05
—
1659339919
—
WI
05
—
30661900
—
WI
01
—
JOHNSTAD
MERCYCARE INSURANCE
WI
Enumeration date
05/03/2006
Last updated
09/06/2012
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