Individual
DR. SCOTT RAYMOND JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12 HIGH ST STE 401, LEWISTON, ME 04240-7690
(207) 795-5767
(207) 795-2732
Mailing address
12 HIGH ST, LEWISTON, ME 04240-7676
(207) 795-5767
(207) 795-2732
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
216275
MA
208600000X
Surgery Physician
Primary
MD21930
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184144
MASSHEALTH
MA
01
—
216275
TUFTS HEALTH PLAN
MA
01
—
J25610
BLUE CROSS
MA
Enumeration date
01/24/2006
Last updated
03/17/2018
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