Individual
DR. BYRON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1944 SHRYER AVE W, ROSEVILLE, MN 55113-5415
(651) 633-9080
Mailing address
856 MANOMIN AVE, SAINT PAUL, MN 55107-3512
(651) 227-4848
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18769
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900282100
—
MN
Enumeration date
12/04/2013
Last updated
12/04/2013
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