Individual
KATHERINE M. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
119 BELMONT ST, WORCESTER, MA 01605-2903
(508) 334-0550
(508) 334-8412
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
265750
MA
207VM0101X
Maternal & Fetal Medicine Physician
Primary
265750
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110116654A
—
MA
Enumeration date
06/08/2012
Last updated
09/03/2021
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