Johansen, Michael W.

Johansen, Michael W. is an individual health care provider with primary practice located at 705 Riley Hospital Dr Ri 1134, Indianapolis IN 46202-5109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Cardiology, which is considered as his primary health care specialty. Johansen, Michael W. can be contacted via phone (317) 944-8906.

Contact Information

Primary practice address
705 Riley Hospital Dr Ri 1134 Indianapolis IN 46202-5109
Phone: (317) 944-8906
Fax: (317) 944-9330
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 02003367 Indiana

Profile Details

NPI number 1578772158
LBN Legal business name Johansen, Michael W.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 21st, 2007
Last updated Jan 13th, 2021 - about 3 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 1578772158 NPPES
Indiana MEDICAID 201077240

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