Individual
DR. HEIDI J. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2035 ASHER CT, SUITE 200, EAST LANSING, MI 48823-8480
(517) 337-8568
(517) 337-8577
Mailing address
PO BOX 13008, LANSING, MI 48901-3008
(517) 364-6253
(517) 364-6208
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013000
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853301194
BCBS INDIVIDUAL PIN #
MI
01
—
200000002863
PHP
MI
05
—
4928573
—
MI
Enumeration date
09/02/2006
Last updated
12/31/2007
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