Gudjonsson, Johann Eli

Gudjonsson, Johann Eli is an individual health care provider with primary practice located at 1500 E Medical Center Dr 1St Floor Taubman Ctr Recp B, Ann Arbor MI 48109-5314. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Gudjonsson, Johann Eli can be contacted via phone (734) 936-4054.

Contact Information

Primary practice address
1500 E Medical Center Dr 1St Floor Taubman Ctr Recp B Ann Arbor MI 48109-5314
Phone: (734) 936-4054
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 4301082622 Michigan
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X 4301082622 Michigan

Profile Details

NPI number 1710004866
LBN Legal business name Gudjonsson, Johann Eli
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2007
Last updated Mar 19th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710004866 NPPES
Michigan Other 5315015456 CONTROLLED SUBSTANCE LICE

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