Individual
DR. GRAHAM ROBERT JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 UNIVERSITY BLVD RM 663, INDIANAPOLIS, IN 46202-5149
(317) 944-1866
Mailing address
3750 W 46TH ST, INDIANAPOLIS, IN 46228-6798
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01080427A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11017982A
IN
Other
Enumeration date
07/08/2013
Last updated
08/19/2020
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