Individual
JEFFREY RICHARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 993-4049
Mailing address
400 MACK AVE, DETROIT, MI 48201-2136
(313) 993-4049
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
13402
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3089171
—
NH
Enumeration date
01/23/2006
Last updated
06/02/2025
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