MEDICARE: PETER EDWIN JOHNSTON DO

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
1	207X00000X	Orthopaedic Surgery Physician	34 00 1146	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184693608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER EDWIN JOHNSTON DO

Provider Business Mailing Address
First Line	:	5350 FRANTZ RD
Second Line	:
City	:	DUBLIN
State	:	OH
Zip	:	43016-4259
Country	:	US
Telephone Number	:	614-544-6355
Fax Number	:	614-544-6350

Provider Business Practice Location Address
First Line	:	5131 BEACON HILL RD
Second Line	:	SUITE 160
City	:	COLUMBUS
State	:	OH
Zip	:	43228-4442
Country	:	US
Telephone Number	:	614-544-1837
Fax Number	:	614-544-2816

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	08/03/2010

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Directions to “ PETER EDWIN JOHNSTON DO” Practice Location

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