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Individual

ROBERT DALE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
130 FISHER RD, CENTRAL VERMONT HOSPITAL, BERLIN, VT 05602-9516
(802) 371-4249
Mailing address
2759 CROSSTOWN RD, BERLIN, VT 05602-9036
(802) 223-5122

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
042-0005945
VT
2085N0700X
Neuroradiology Physician
042-0005945
VT
2085N0904X
Nuclear Radiology Physician
042-0005945
VT
2085P0229X
Pediatric Radiology Physician
042-0005945
VT
2085R0202X
Diagnostic Radiology Physician
Primary
042-0005945
VT
2085R0204X
Vascular & Interventional Radiology Physician
042-0005945
VT
2085U0001X
Diagnostic Ultrasound Physician
042-0005945
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00005065
BLUE SHIELD
VT
05
0005065
VT
Enumeration date
09/27/2006
Last updated
09/01/2013
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