Individual
BLAKE ALLAN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 FRUIT ST GRB-425, BOSTON, MA 02114-2696
(617) 726-2800
Mailing address
55 FRUIT ST GRB 425, BOSTON, MA 02114-2696
(617) 726-2800
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
3016538
MA
Other
Enumeration date
12/27/2017
Last updated
06/06/2024
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