Individual
VIJAY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-1000
(262) 434-5050
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
60593
WI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
60593
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100031349
—
WI
05
—
1023298072
—
WI
Enumeration date
11/07/2007
Last updated
09/13/2023
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