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Individual

ALAN STUART JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3960 COON RAPIDS BLVD NW, SUITE 104, COON RAPIDS, MN 55433-2569
(763) 236-9000
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32879
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
444273300
MN
Enumeration date
04/04/2006
Last updated
10/19/2011
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