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General NPI Number Information
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NPI Number | 1962823849
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Entity Type | Organization
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Legal Business Name | MICHELLE JOHNSTON MD
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Dates
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Enumeration Date | 12/19/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 537 PRITCHARD RD
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City | WEST WINFIELD
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State | NY
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Zip | 13491-3620
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Country | US
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Telephone | 315-525-5653
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Fax |
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Provider Business Mailing Address
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Address Line | 537 PRITCHARD RD
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City | WEST WINFIELD
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State | NY
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Zip | 13491-3620
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Country | US
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Telephone | 315-525-5653
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHELLE M JOHNSTON
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Credential | MD
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Telephone | 315-525-5653
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 219360
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License Number State | NY
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