Individual
DR. DAVID K JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1625 RAMBLEWOOD DR, EAST LANSING, MI 48823-6367
(517) 324-3705
(517) 324-4589
Mailing address
2175 COOLIDGE RD, EAST LANSING, MI 48823-1379
(517) 324-3705
(517) 324-4589
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
DJ036689
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000638
MCLAREN
—
05
—
101312174
—
MI
01
—
200000002171
PHYSICIAN HEALTH PLAN
—
01
—
340009577
RAILROAD MEDICARE
—
01
—
340C376010
BLUE CROSS BLUE SHIELD
—
01
—
4496865
AETNA
—
01
—
DR330319
MCARE
—
Enumeration date
10/04/2006
Last updated
01/14/2014
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