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Individual

BRENDA L JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
955 MAIN ST, SUITE 304, WINCHESTER, MA 01890-1961
(781) 729-5651
(781) 729-8523
Mailing address
955 MAIN ST, SUITE 304, WINCHESTER, MA 01890-1961
(781) 729-5651
(781) 729-8523

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
80366
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3185117
MA
Enumeration date
06/05/2006
Last updated
11/05/2010
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