Individual
MICHELE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
60 EAST ST, SUITE 3300, METHUEN, MA 01844-4500
(978) 685-3440
(978) 657-5877
Mailing address
PO BOX 71, C/O KDC MANAGEMENT, TEWKSBURY, MA 01876-0071
(978) 657-5866
(978) 657-5877
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
49865
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0173096
—
MA
01
—
01Y005533MA01
ANTHEM
NH
01
—
1309662
UNITED HEALTHCARE
MA
01
—
13307
HARVARD PILGRIM
MA
01
—
30008466
MEDICAID NH GROUP
NH
01
—
30205174
MEDICAID OF NH INDIV
NH
01
—
51762
FALLON GROUP NUMBER
MA
01
—
611003
TUFTS GROUP NUMBER
MA
01
—
6967
FALLON
MA
01
—
708116
TUFTS INDIV.NUMBER
MA
01
—
978403
NETWORK GROUP NUMBER
MA
05
—
9787143
—
MA
01
—
98207101
NETWORK INDIV NUMBER
MA
01
—
D13217
BC/BS INDIVIDUAL #
MA
01
—
M17489
BC/BS GROUP NUMBER
MA
01
—
NEIGHBORHOOD HEALTH
1801562
MA
Enumeration date
08/20/2006
Last updated
11/03/2008
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