Individual
DR. SAMUEL STUART JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1058 COLLEGE DR, NEW TOWN, ND 58763-9112
(701) 627-4750
(888) 877-8471
Mailing address
315 MAIN ST # 676, NEW TOWN, ND 58763-4000
(385) 414-1376
(888) 877-8471
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12967
NV
207Q00000X
Family Medicine Physician
Primary
6454773-1205
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003763400
—
ID
Enumeration date
08/12/2005
Last updated
05/08/2015
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