Individual
CAMILLE ELISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20905 GREENFIELD RD STE 600, SOUTHFIELD, MI 48075-5355
(586) 646-2100
(586) 327-1441
Mailing address
19785 W 12 MILE RD # 591, SOUTHFIELD, MI 48076-2584
(586) 646-2100
(586) 327-1441
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
4301061672
MI
207R00000X
Internal Medicine Physician
4301061672
MI
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
4301061672
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108235612
BCN
MI
05
—
4706904
—
MI
Enumeration date
02/24/2006
Last updated
10/17/2025
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