Individual
STEVEN M JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
908 RIDGEWOOD CT., CONNERSVILLE, IN 47331-1264
(765) 265-5756
Mailing address
908 RIDGEWOOD CT., CONNERSVILLE, IN 47331-1264
(765) 265-5756
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02002166A
IN
207V00000X
Obstetrics & Gynecology Physician
2015015367
MO
207V00000X
Obstetrics & Gynecology Physician
46941-21
WI
207V00000X
Obstetrics & Gynecology Physician
DO-03490
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000335812
BLUE CROSS
IN
01
—
000000977633
ANTHEM
IN
05
—
200182600
—
IN
Enumeration date
03/17/2006
Last updated
04/06/2017
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