Individual
DR. MARK HERBERT JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2104 OLIVER AVE S, MINNEAPOLIS, MN 55405-2437
(612) 377-6084
Mailing address
2104 OLIVER AVE S, MINNEAPOLIS, MN 55405-2437
(612) 377-6084
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
19187
MN
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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