Individual
MICHAEL G JOHANSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
410 WEST TENTH AVE, N429 DOAN HALL, COLUMBUS, OH 43210
(614) 293-4705
(614) 293-8153
Mailing address
660 ACKERMAN 3RD FLOOR, PO BOX 183103, COLUMBUS, OH 43218-3103
(614) 293-2150
(614) 293-6479
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
34002549
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0841647
—
OH
Enumeration date
04/22/2006
Last updated
07/08/2007
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