Individual
DR. FREDERICK W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 OSBORNE RD NE, SUITE 200, FRIDLEY, MN 55432-2765
(763) 236-2045
(763) 236-2044
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
19185
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
670892700
—
MN
Enumeration date
10/04/2006
Last updated
11/29/2011
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