Johnson, Derick Michael
Johnson, Derick Michael is an individual health care provider with primary practice located at 3299 N Wellness Dr Bldg C, #150, Holland MI 49424-7269. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Johnson, Derick Michael can be contacted via phone (616) 738-3884.Contact Information
Primary practice address
3299 N Wellness Dr Bldg C, #150
Holland MI 49424-7269
Phone: (616) 738-3884
Fax: (616) 738-4432
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 58.001489 | Ohio |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 0102202412 | Virginia |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | L1206639 | Michigan |
Profile Details
| NPI number | 1972768232 |
|---|---|
| LBN Legal business name | Johnson, Derick Michael |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 25th, 2008 |
| Last updated | Jul 23rd, 2014 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972768232 | NPPES |
| Virginia | Other | 0102202412 | LICENSE |
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