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:
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Health care specialties

SpecialtyCodeLicense #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 11 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 1972768232 NPPES
Virginia Other 0102202412 LICENSE

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