Individual
JEREMY TODD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
27100 CHARDON RD, RICHMOND HEIGHTS, OH 44143-1116
(440) 585-7006
(440) 585-6269
Mailing address
3115 BERKSHIRE RD, CLEVELAND HEIGHTS, OH 44118-2423
(269) 217-2244
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34.012569
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2010
Last updated
01/14/2021
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