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Individual

DOUGLAS A. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
230 W OAK ST, SUITE 201, FREMONT, MI 49412-1575
(231) 924-4200
(231) 924-2001
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
047515
MI

Other

Enumeration date
05/17/2006
Last updated
03/10/2014
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