Michael P. Johnson, Md, Inc | |
148 W River St Ste 22b Providence RI 02904 | |
(401) 521-7100 | |
(401) 521-7102 |
Full Name | Michael P. Johnson, Md, Inc |
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Speciality | Internal Medicine |
Location | 148 W River St Ste 22b, Providence, Rhode Island |
Authorized Official Name and Position | Carla M. Martin (OFFICE MANAGER) |
Authorized Official Contact | 4015217100 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Michael P. Johnson, Md, Inc 148 W River St Ste 22b Providence RI 02904-2628 Ph: (401) 521-7100 | Michael P. Johnson, Md, Inc 148 W River St Ste 22b Providence RI 02904 Ph: (401) 521-7100 |
NPI Number | 1588161608 |
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Provider Enumeration Date | 04/06/2018 |
Last Update Date | 04/29/2022 |
Medicare PECOS PAC ID | 2860756327 |
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Medicare Enrollment ID | O20180509000627 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588161608 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD09266 (Rhode Island) | Primary |
Provider Name | Michael P Johnson |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1366480592 PECOS PAC ID: 0143200378 Enrollment ID: I20040720001198 |
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