Individual
DR. EWANAH D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 983-8300
(269) 985-4535
Mailing address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 985-4632
(269) 985-4535
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35078873J
OH
207R00000X
Internal Medicine Physician
Primary
4301091013
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1538397120
GROUP NPI
MI
05
—
1841282456
—
MI
05
—
2325228
—
OH
01
—
270381199
GROUP TAX ID
MI
Enumeration date
08/19/2005
Last updated
05/20/2015
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