Individual
MR. MICHAEL JOEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6099 WAYZATA BLVD, ST LOUIS PARK, MN 55416-5538
(952) 204-5060
Mailing address
3900 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2505
(952) 993-3150
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2818
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
133059
UCARE
MN
01
—
22-03338
MEDICA
MN
01
—
531P4JO
BCBS
MN
01
—
A01991033717
PREFERRED ONE
MN
01
—
HP64503
HEALTH PARTNERS
MN
01
—
OP6854
EYEMED
MN
Enumeration date
02/26/2007
Last updated
03/09/2026
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