Individual
PAMELA D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4100 JOHN R ST, KARMANOS CANCER CENTER, DETROIT, MI 48201-2013
(800) 527-6266
(313) 576-8699
Mailing address
1420 STEPHENSON HWY, SUITE 400-CREDENTIALING, TROY, MI 48083-1189
(248) 581-5974
(248) 581-5640
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301048870
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0633185
BCBS
MA
01
—
102263
PREFERRED CHOICES
MI
01
—
2422609003
CIGNA
MI
01
—
4133392
AETNA
MI
01
—
74717A
HEALTH ALLIANCE PLAN
MA
01
—
B8910
MCARE
MA
01
—
P71138
BLUE CHOICE
MI
Enumeration date
02/26/2007
Last updated
01/17/2014
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