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Individual

MATTHEW T JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
125055475
IL
208800000X
Urology Physician
Primary
16113
NH

Other

Enumeration date
09/03/2008
Last updated
07/01/2013
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