Individual
DR. ERIC MATTHEW JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2545 CHICAGO AVE, SUITE 601, MINNEAPOLIS, MN 55404-4522
(612) 863-7770
(612) 863-7772
Mailing address
260 WOODLAWN AVE, SAINT PAUL, MN 55105-1237
(651) 699-4242
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36808
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07D69JO
BLUE CROSS BLUE SHIELD
MN
01
—
107252D417
UCARE
MN
01
—
1711761
MEDICA
MN
01
—
32072100
WISCONSIN MA
MN
05
—
845718200
—
MN
01
—
HP28250
HEALTHPARTNERS
MN
Enumeration date
05/16/2006
Last updated
09/12/2012
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