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Individual

JULIE K JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
1105 6TH ST, TRAVERSE CITY, MI 49684-2349
(231) 947-0673
(801) 740-2847
Mailing address
4624 N SPIDER LAKE RD, TRAVERSE CITY, MI 49696-8440
(231) 947-0673
(801) 740-2847

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
5101011139
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3064262
MI
01
930018880
RAILROAD MEDICARE
MI
01
JJ011139
BLUE CROSS BLUE SHIELD
MI
Enumeration date
06/21/2005
Last updated
01/07/2020
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