Individual
DR. BRADLEY D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9825 HOSPITAL DR STE 203, MAPLE GROVE, MN 55369-4772
(763) 233-5755
Mailing address
8301 GOLDEN VALLEY RD, STE 200, GOLDEN VALLEY, MN 55427
(763) 233-5755
(763) 233-5782
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
45555
MN
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
45555
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323630700
—
MN
Enumeration date
01/27/2006
Last updated
08/15/2025
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