Individual
BERNARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
036-048439
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008456
HEALTH ALLIANCE
IL
05
—
036048439
—
IL
Enumeration date
08/05/2006
Last updated
05/21/2012
Update your record
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