Individual
DR. MICHAEL GEORGE JOHNSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28 CRESCENT ST, MIDDLETOWN, CT 06457-3654
(860) 358-6293
Mailing address
57 S MAIN ST, MIDDLETOWN, CT 06457-3606
(860) 638-0050
(860) 346-8836
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
052808
CT
2085R0204X
Vascular & Interventional Radiology Physician
Primary
052808
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008053944
—
CT
Enumeration date
07/08/2008
Last updated
11/21/2023
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