Individual
BRUCE G JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150
(734) 464-0887
(734) 402-0254
Mailing address
36123 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
007447
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2608252
—
MI
05
—
2643592
—
MI
05
—
2832400
—
MI
Enumeration date
06/24/2005
Last updated
08/28/2018
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