Individual
KEITH W. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 BAYVIEW DR, ROSEVILLE, MN 55113-6907
(651) 665-0413
Mailing address
450 BAYVIEW DR, ROSEVILLE, MN 55113-6907
(651) 665-0413
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
18624
MN
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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