Individual
RENATE A JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1343 N FOUNTAIN BLVD, SPRINGFIELD, OH 45504-1422
(937) 390-5000
(937) 390-5526
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35062184J
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000302753
BCBS
OH
05
—
0863954
—
OH
01
—
P00088334
RAIL ROAD MEDICARE
—
Enumeration date
05/12/2006
Last updated
05/29/2008
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