Individual
JOEL A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 LAKESHORE DR., ISHPEMING, MI 49849
(906) 485-2696
(906) 485-2728
Mailing address
901 LAKESHORE DR, ISHPEMING, MI 49849
(906) 485-2696
(906) 485-2728
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
4301057398
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3123800
—
MI
01
—
3305200671
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
12/01/2005
Last updated
04/26/2012
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