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NPI Code Detail

MEDICARE: DR. MICHAEL J. JOHNSON M.D.

MEDICARE: DR. MICHAEL J. JOHNSON M.D.
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
1207RC0000XCardiovascular Disease Physician35.127754OH
2207RC0000XCardiovascular Disease Physician57.022380OH
3207R00000XInternal Medicine Physician0101253138VA
4207RC0000XCardiovascular Disease Physician79999GA
5390200000XStudent in an Organized Health Care Education/Training Program
6207RI0011XInterventional Cardiology Physician7999GA
7207RC0000XCardiovascular Disease Physician079999GA

General Provider Information

NPI Number : 1093959553
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL J. JOHNSON M.D.
Provider Business Mailing Address
First Line : 9500 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44195-0001
Country : US
Telephone Number : 216-444-2200
Fax Number : 216-445-6148
Provider Business Practice Location Address
First Line : 1348 WALTON WAY STE 5100
Second Line :
City : AUGUSTA
State : GA
Zip : 30901-5108
Country : US
Telephone Number : 706-724-8611
Fax Number : 706-724-6202
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2009
Last Update Date : 12/27/2023

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