Individual
DR. MARCIA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2854 S 11TH ST, KALAMAZOO, MI 49009-2129
(269) 345-6197
(269) 345-9734
Mailing address
2854 S 11TH ST, KALAMAZOO, MI 49009-2129
(269) 345-6197
(269) 345-9734
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MJ061404
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
160038775
RAILROAD MEDICARE
—
01
—
1603903372
BLUE CROSS BLUE SHIELD
MI
05
—
3353265
—
MI
01
—
731899
PHP
—
Enumeration date
09/13/2005
Last updated
02/01/2022
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