Individual
JAMES R JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5400 FORT ST, SUITE 130, TRENTON, MI 48183-4632
(734) 362-7100
(734) 671-1768
Mailing address
5400 FORT ST, SUITE 130, TRENTON, MI 48183-4632
(734) 362-7100
(734) 671-1768
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5101014114
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110H232900
BCBS
MI
01
—
1158215544
BCBS - INDIVIDUAL
MI
01
—
E42955
HAP
MI
Enumeration date
04/13/2006
Last updated
12/01/2011
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