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NPI Code Detail

MEDICARE: MR. ROBERT E JOHNSON MSW

MEDICARE: MR. ROBERT E JOHNSON MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker571-123WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427225507
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBERT E JOHNSON MSW
Provider Business Mailing Address
First Line : 4957 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-2324
Country : US
Telephone Number : 414-873-1960
Fax Number : 414-873-4990
Provider Business Practice Location Address
First Line : 4957 W FOND DU LAC AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53216-2324
Country : US
Telephone Number : 414-873-1960
Fax Number : 414-873-4990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2008
Last Update Date : 12/21/2025

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