Individual
MARY E JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
29 CRAFTS ST SUITE 400, NEWTON, NEWTON, MA 02458-1393
(617) 964-7530
Mailing address
1611 CAMBRIDGE ST, CAMBRIDGE, MA 02138-4302
(617) 661-5100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
216904
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2801636
—
MA
Enumeration date
09/27/2005
Last updated
09/02/2015
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