Johnson, David Martin

Johnson, David Martin is an individual health care provider with primary practice located at 2300 N Edward Str , Decatur IL 62526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Johnson, David Martin can be contacted via phone (217) 876-5021.

Contact Information

Primary practice address
2300 N Edward Str Decatur IL 62526
Phone: (217) 876-5021
Fax: (217) 876-5013
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X Illinois

Profile Details

NPI number 1922014455
LBN Legal business name Johnson, David Martin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Jul 8th, 2007 - about 17 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 1922014455 NPPES
Illinois MEDICAID 0360580891

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