Individual
NATHAN SAMUEL JOHNSON
Active
Individual
NATHAN SAMUEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
01072715A
IN
390200000X
Student in an Organized Health Care Education/Training Program
11015540A
IN
Other
Enumeration date
06/08/2010
Last updated
05/20/2014
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