Individual
DR. MARK R. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 MADISON AVE, MORRISTOWN, NJ 07960-6136
(973) 971-7165
(973) 290-7521
Mailing address
PO BOX 23831, NEWARK, NJ 07189-0831
(973) 971-7184
(973) 290-8349
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
25MA08685600
NJ
207RN0300X
Nephrology Physician
Primary
25MA08685600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02784701
—
NY
Enumeration date
08/23/2006
Last updated
01/07/2010
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