Individual
MICHAEL D. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3533 SOUTHERN BLVD STE 5200, KETTERING, OH 45429-1275
(937) 435-8663
(937) 435-8966
Mailing address
3533 SOUTHERN BLVD STE 5200, KETTERING, OH 45429-1275
(937) 435-8966
(937) 435-8966
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
35092049
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2849412
—
OH
Enumeration date
04/01/2008
Last updated
07/15/2021
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