Johnson, Denise Roberts

Johnson, Denise Roberts is an individual health care provider with primary practice located at 6973 Olive Blvd , University City MO 63130-2540. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Johnson, Denise Roberts can be contacted via phone (314) 862-7515.

Contact Information

Primary practice address
6973 Olive Blvd University City MO 63130-2540
Phone: (314) 862-7515
Fax: (314) 862-9214
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X R9G45 Missouri
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X R9G45 Missouri

Profile Details

NPI number 1285793356
LBN Legal business name Johnson, Denise Roberts
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2006
Last updated Dec 12th, 2011 - 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 1285793356 NPPES
Missouri MEDICAID 202402210

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