Individual
MERRICK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5225 23RD AVE S, FARGO, ND 58104-7927
(701) 417-1334
Mailing address
1919 ELM ST N, FARGO, ND 58102-2416
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
19972
ND
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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