Michael A Johnson, MD | |
801 S 70th St, West Allis, WI 53214-3147 | |
(414) 773-6600 | |
(414) 773-6656 |
Full Name | Michael A Johnson |
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Gender | Male |
Speciality | Pediatrics |
Location | 801 S 70th St, West Allis, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1366403743 | NPI | - | NPPES |
32485000 | Medicaid | WI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 38024 (Wisconsin) | Primary |
Entity Name | Columbia St Marys Hospital Milwaukee Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1023064482 PECOS PAC ID: 5890604722 Enrollment ID: O20031105000057 |
Mailing Address | Practice Location Address |
---|---|
Michael A Johnson, MD 4425 N Port Washington Rd, Attn: Clinic Credentialing, Glendale, WI 53212-1082 Ph: (414) 773-6600 | Michael A Johnson, MD 801 S 70th St, West Allis, WI 53214-3147 Ph: (414) 773-6600 |
Dr. Lisa M Stukenberg, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 555 S 108th St, West Allis, WI 53214 Phone: 414-566-6400 Fax: 414-566-3866 | |
Stephanie J Slock, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 8905 W Lincoln Ave Ste 409, West Allis, WI 53227 Phone: 414-328-8770 | |
Elizabeth W Ciurlik, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 8901 W Lincoln Ave, West Allis, WI 53227 Phone: 414-328-6000 | |
Feridoun Beroukhim, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2424 S 90th St, Ste 504, West Allis, WI 53227 Phone: 414-328-8670 | |
Andrew P Swietlik, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2323 S 102nd St, West Allis, WI 53227 Phone: 414-541-9900 |