Individual
DR. KIM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3409 LUDINGTON ST, SUITE 204, ESCANABA, MI 49829-4212
(906) 786-1356
(906) 789-4503
Mailing address
3409 LUDINGTON ST, SUITE 204, ESCANABA, MI 49829-4212
(906) 786-1356
(906) 789-4503
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5101013033
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1922058361
—
MI
01
—
5211399
BCBS
—
Enumeration date
05/10/2006
Last updated
03/31/2010
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