Individual
DR. MICHAEL C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 PARK AVE, WILLISTON, VT 05495-9701
(802) 878-1008
Mailing address
28 PARK AVE, WILLISTON, VT 05495-9701
(802) 878-1008
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0420010982
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02667614
—
NY
05
—
1011709
—
VT
Enumeration date
08/07/2006
Last updated
11/24/2014
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