Individual
JEREMIAH L JOHNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 MICHIGAN ST NW STE 200, GRAND RAPIDS, MI 49503-2302
(616) 330-2522
Mailing address
109 MICHIGAN ST NW STE 200, GRAND RAPIDS, MI 49503-2302
(616) 330-2522
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
4301083940
MI
207P00000X
Emergency Medicine Physician
Primary
4301083940
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301083940
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00406843
RAILROAD MEDICARE
MI
Enumeration date
12/15/2006
Last updated
04/21/2022
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