Individual
MICHELLE RULLAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
119 WINDSOR ST, CAMBRIDGE, MA 02139-3647
(617) 665-3600
Mailing address
10 BEACON ST, SOMERVILLE, MA 02143-4311
(617) 394-7703
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
265139
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
265139
MA
261QP2300X
Primary Care Clinic/Center
265139
MA
314000000X
Skilled Nursing Facility
265139
MA
Other
Enumeration date
04/30/2012
Last updated
12/19/2025
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