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General NPI Number Information
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NPI Number | 1902913239
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Entity Type | Individual
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Provider Name | DAVID LEE JOHNSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 8400 NORMANDALE LAKE BLVD STE 920
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City | BLOOMINGTON
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State | MN
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Zip | 55437-3843
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Country | US
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Telephone | 952-395-7212
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Fax | 952-831-0530
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Provider Business Mailing Address
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Address Line | 8400 NORMANDALE LAKE BLVD STE 920
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City | BLOOMINGTON
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State | MN
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Zip | 55437-3843
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Country | US
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Telephone | 952-395-7212
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Fax | 952-831-0530
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G54829
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 27456
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License Number State | MN
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