Individual
MR. MICHAEL D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
502 W HARRIE ST, NEWBERRY, MI 49868-1209
(906) 293-9233
(906) 293-9285
Mailing address
502 W HARRIE ST, NEWBERRY, MI 49868-1209
(906) 293-9233
(906) 293-9285
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002886
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5411366
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/29/2006
Last updated
06/24/2009
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