Individual
MATTHEW L JOHNSON
Active
Individual
MATTHEW L JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME012756
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040224
ANTHEM
ME
01
—
100504700
OWCP
ME
01
—
108913
MARTIN'S POINT
ME
05
—
228090000
—
ME
Enumeration date
01/01/2007
Last updated
07/23/2018
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