Individual
MR. MATTHEW YOUNG JOHNSON
Active
Individual
MR. MATTHEW YOUNG JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA.509
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009942984
—
AL
01
—
51005353
BLUE CROSS
AL
Enumeration date
02/21/2007
Last updated
10/25/2018
Update your record
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