Individual
BENJAMIN H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4190 LOBERG AVE, DULUTH, MN 55811-2652
(218) 249-5700
(218) 249-4666
Mailing address
4190 LOBERG AVE, DULUTH, MN 55811-2652
(218) 249-5700
(218) 249-4666
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30419
WI
207Q00000X
Family Medicine Physician
Primary
39802
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31750700
—
WI
Enumeration date
06/23/2005
Last updated
01/27/2017
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