Individual
MICHAEL W JOHNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1801 16TH ST, GREELEY, CO 80631-5154
(970) 378-4433
Mailing address
1441 N 12TH ST, PHOENIX, AZ 85006-2837
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39436
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77174879
—
CO
Enumeration date
07/13/2006
Last updated
12/04/2009
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