Individual
JUDD C JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 LAKESHORE DR, ISHPEMING, MI 49849-1367
(906) 485-2634
(906) 485-2344
Mailing address
901 LAKESHORE DR, ISHPEMING, MI 49849-1367
(906) 485-2634
(906) 485-2344
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
4301050861
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1862790
—
MI
01
—
220016108
RAILROAD MEDICARE
—
01
—
2205245571
BLUE SHIELD
MI
Enumeration date
05/19/2006
Last updated
06/13/2013
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