Individual
DR. NATHAN ALLEN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3572 BRODHEAD RD, SUITE 201, MONACA, PA 15061-3101
(724) 728-6539
(724) 728-7416
Mailing address
3572 BRODHEAD RD, SUITE 201, MONACA, PA 15061-3101
(724) 728-6539
(724) 728-7416
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD433869
PA
2085R0202X
Diagnostic Radiology Physician
MT183509
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1021877070001
—
PA
01
—
2045019
BLUE CROSS BLUE SHIELD
PA
05
—
3810013349
—
WV
Enumeration date
08/01/2007
Last updated
04/16/2012
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