Individual
DR. MATTHEW EDWARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1475 KISKER RD STE 180, SAINT CHARLES, MO 63304-8786
(636) 442-7300
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
036140409
IL
2085R0001X
Radiation Oncology Physician
Primary
2015001562
MO
2085R0001X
Radiation Oncology Physician
MD446623
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952612020
—
MO
Enumeration date
06/23/2010
Last updated
06/26/2024
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