Individual
STEVE R JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2320 N LAKE DR, ROOM 3603, MILWAUKEE, WI 53211-4507
(414) 270-4932
Mailing address
4425 N PORT WASHINGTON RD, ATTN: CLINIC CREDENTIALING, GLENDALE, WI 53212-1082
(414) 270-4932
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
44862
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34243400
—
WI
Enumeration date
10/13/2006
Last updated
02/11/2013
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