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General NPI Number Information
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NPI Number | 1952389306
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Entity Type | Individual
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Provider Name | DAVID EMANUEL JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 04/11/2022
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Provider Practice Location Address
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Address Line | 40520 COUNTY HIGHWAY 34
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City | OGEMA
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State | MN
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Zip | 56569-9612
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Country | US
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Telephone | 218-983-4300
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Fax | 218-983-6307
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Provider Business Mailing Address
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Address Line | 40520 COUNTY HIGHWAY 34
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City | OGEMA
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State | MN
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Zip | 56569-9612
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Country | US
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Telephone | 218-983-4300
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Fax | 218-983-6307
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD2004-0358
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License Number State | NM
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