Individual
NIEL A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16985 W BLUEMOUND RD, BROOKFIELD, WI 53005-5909
(262) 641-8400
(910) 369-2874
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35197
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100044449
—
WI
Enumeration date
04/07/2006
Last updated
05/13/2024
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