=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063658011
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT T. JOHNSTON MD PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2008
-----------------------------------------------------
Last Update Date | 12/22/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1400 LOCUST STREET SUITE 5106
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-471-3061
-----------------------------------------------------
Fax | 412-471-6621
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1400 LOCUST STREET SUITE 5106
-----------------------------------------------------
City | PITTSBURGH
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15219
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 412-471-3061
-----------------------------------------------------
Fax | 412-471-6621
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. ROBERT THOMAS JOHNSTON
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 412-471-3061
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | MD015363E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------