Individual
GARY MICHAEL JOHNSTON
Active
Individual
GARY MICHAEL JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO R5613
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110213633
RAILROAD MEDICARE
MO
05
—
240233429
—
MO
01
—
2762200003
CIGNA HEALTHCARE OF KANSAS/MISSOURI, INC
MO
01
—
4534129
AETNA US HEALTHCARE
MO
Enumeration date
06/05/2006
Last updated
09/02/2010
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