Individual
MICHELE H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20 YORK ST, YNHH SOUTH PAVILION - 2ND FLOOR, NEW HAVEN, CT 06510-3220
(203) 688-2433
(203) 688-9258
Mailing address
300 GEORGE ST, 6TH FLOOR, PO BOX 9805, NEW HAVEN, CT 06536-0805
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
037637
CT
2085R0202X
Diagnostic Radiology Physician
037637
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001376377
—
CT
Enumeration date
11/14/2005
Last updated
07/22/2008
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