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Individual

WALTER G JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
150 N SYKES CREEK PKWY, # 300, MERRITT ISLAND, FL 32953-3488
(321) 452-3811
(321) 454-4026
Mailing address
PO BOX 11406, BELFAST, ME 04915-4005
(321) 452-3811
(321) 454-4026

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME56254
FL
207RC0000X
Cardiovascular Disease Physician
Primary
ME56254
FL
207RI0011X
Interventional Cardiology Physician
ME56254
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
069823700
FL
Enumeration date
08/08/2006
Last updated
09/06/2016
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