Individual
DR. GARY KEITH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., M.P.H.
Contact information
Practice address
630 S SAGINAW ST, FLINT, MI 48502-1525
(810) 257-3155
(810) 257-3147
Mailing address
630 S SAGINAW ST, FLINT, MI 48502-1525
(810) 257-3155
(810) 257-3147
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301049794
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2837685
—
MI
05
—
3149584
—
MI
05
—
3149593
—
MI
Enumeration date
02/02/2007
Last updated
07/09/2007
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