Individual
BENJAMIN KEITH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 6TH AVENUE NORTH, CENTRACARE CLINIC RIVER CAMPUS, ST CLOUD, MN 56303-2735
(320) 656-7020
(320) 255-5943
Mailing address
1200 6TH AVENUE NORTH, CENTRACARE CLINIC RIVER CAMPUS, ST CLOUD, MN 56303-2735
(320) 656-7020
(320) 255-5943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
55329
MN
207RC0000X
Cardiovascular Disease Physician
Primary
55329
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2011
Last updated
07/21/2022
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