Individual
TERRY M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 E BROADWAY AVE, BISMARCK, ND 58501-4520
(701) 530-7000
(701) 530-8842
Mailing address
900 E BROADWAY AVE, P.O. BOX 997, BISMARCK, ND 58501-4520
(701) 530-7000
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5453
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15621
—
ND
01
—
260014575
RR MEDICARE
ND
Enumeration date
10/26/2006
Last updated
06/22/2010
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