Individual
CRAIG H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 SMITH AVE N STE 700, SAINT PAUL, MN 55102-2972
(651) 241-3535
Mailing address
310 SMITH AVE N STE 303, SAINT PAUL, MN 55102-2393
(651) 241-5111
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
30848
MN
208200000X
Plastic Surgery Physician
60797-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
240003573
RAILROAD MEDICARE
MN
05
—
35175400
—
WI
Enumeration date
01/12/2006
Last updated
03/11/2021
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