Individual
DR. MILTON CHARLES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10000 SE MAIN ST STE 112, PORTLAND, OR 97216-2441
(503) 255-3054
(503) 255-7651
Mailing address
10000 SE MAIN ST STE 112, PORTLAND, OR 97216-2441
(503) 255-3054
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
76094
WI
207RG0100X
Gastroenterology Physician
Primary
CP204575
OR
207RG0100X
Gastroenterology Physician
ME65674
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010351500
—
FL
05
—
100181212
—
WI
01
—
25052
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/08/2006
Last updated
09/10/2024
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