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Individual

STEVEN PAUL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4 SHAWS CV, STE 103, NEW LONDON, CT 06320-4956
(860) 443-3778
(860) 443-8820
Mailing address
4 SHAWS CV, STE 103, NEW LONDON, CT 06320-4956
(860) 443-3778
(860) 443-8820

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27140
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004071320
CT
Enumeration date
06/21/2005
Last updated
07/08/2007
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