Individual
SCOTT JOHANNING
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
44201 DEQUINDRE, 400 FSC - PCS, TROY, MI 48085-1198
(248) 423-3144
Mailing address
3601 W 13 MILE RD, 400 FSC - PCS, ROYAL OAK, MI 48073-6769
(248) 423-3144
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704143880
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3011877
—
MI
Enumeration date
03/21/2006
Last updated
07/08/2007
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