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Individual

MARTHA ANNE JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
415 BYERS RD, STE 300, MIAMISBURG, OH 45342-3684
(937) 866-2494
(937) 866-8494
Mailing address
415 BYERS RD, STE 300, MIAMISBURG, OH 45342-3684
(937) 866-2494
(937) 866-8494

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35.050078
OH
207Q00000X
Family Medicine Physician
Primary
35050078J
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0658681
MEDICARE PTAN
OH
01
0658686
MEDICARE PTAN
OH
05
153891
OH
01
JO0658682
MEDICARE PTAN
OH
Enumeration date
12/29/2005
Last updated
01/20/2021
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