Individual
MICHAEL K. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11642 WEST FLORISSANT, SAINT LOUIS, MO 63033
(314) 838-8220
(314) 838-8091
Mailing address
5701 DELMAR BLVD., SAINT LOUIS, MO 63112
(314) 367-7848
(314) 367-2985
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
R7701
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200642233
—
MO
Enumeration date
06/26/2006
Last updated
08/11/2011
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