Individual
ANDREW J JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
1245 S WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
(218) 846-2114
Mailing address
1245 S WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
(218) 846-2114
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
801
MN
213E00000X
Podiatrist
PO00000770
WA
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
801
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0196122
L & I
WA
01
—
0207841
L & I
WA
05
—
8436453
—
WA
01
—
8905370
CRIME VICTIMS
WA
01
—
8941204
CRIME VICTIMS
WA
01
—
P00235433
RAILROAD
WA
Enumeration date
08/10/2006
Last updated
03/29/2022
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