Individual
ROBERT DALE JOHNSON
Active
Individual
ROBERT DALE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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