Individual
KHAI-EL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Mailing address
637 WASHINGTON ST, DORCHESTER, MA 02124-3510
(617) 825-9660
(617) 288-7898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
285614
MA
207Q00000X
Family Medicine Physician
Primary
MD047107
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110117208A
—
MA
Enumeration date
04/13/2016
Last updated
12/06/2023
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