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Individual
BRUCE WILLIAM JOHNSTON
Active
Individual
BRUCE WILLIAM JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
34612
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160023875
RAILROAD MEDICARE
MN
05
—
35175200
—
WI
05
—
387320000
—
MN
05
—
ENROLLED
—
IA
Enumeration date
01/19/2006
Last updated
10/31/2008
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