Individual
WALTER S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1702 UNIVERSITY DR S, FARGO, ND 58103-4940
(701) 364-3300
(701) 364-8906
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4262
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0402561
MEDICA #
ND
01
—
0404050
MEDICA #
ND
05
—
15078
—
ND
01
—
152020
UCARE #
ND
01
—
15638
SIOUX VALLEY #
ND
01
—
2120
NDBS #
ND
01
—
30224JO
MNBS #
ND
05
—
625005000
—
ND
01
—
79896JO
MNBS #
ND
01
—
79897JO
MNBS #
MN
01
—
80950JO
MNBS #
ND
01
—
910828
AMERICA'S PPO/ARAZ #
ND
01
—
DA9011015546
PREFERRED ONE #
ND
01
—
HP19546
HEALTHPARTNERS #
ND
01
—
ND100004
LHS #
ND
Enumeration date
07/13/2006
Last updated
03/07/2023
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