Individual
JOHN L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-8500
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
35-055255
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224285
UNISON
OH
01
—
000000539570
ANTHEM
OH
01
—
0658858
AETNA
OH
05
—
0737733
—
OH
01
—
363673
WELLCARE
OH
01
—
700006803
RAILROAD MEDICARE
OH
01
—
746011
BUCKEYE
OH
Enumeration date
07/19/2006
Last updated
11/23/2020
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