Johnson, Dwayne Edward

Johnson, Dwayne Edward is an sole proprietor health care provider with primary practice located at 236 Simpson Ave , Elkhart IN 46516-4666. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Johnson, Dwayne Edward can be contacted via phone (574) 584-7373.

Contact Information

Primary practice address
236 Simpson Ave Elkhart IN 46516-4666
Phone: (574) 584-7373
Fax: (574) 293-3744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01073977A Indiana
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 28666 Kentucky

Profile Details

NPI number 1841379187
LBN Legal business name Johnson, Dwayne Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 6th, 2006
Last updated Nov 3rd, 2023 - about 2 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 1841379187 NPPES
Other 611336483 COMMONWEALTH HEALTH ALLIA
Other 611336483 COMMONWEALTH HEALTH ALLIA
Other 611336483 COMMONWEALTH HEALTH ALLIA
MEDICAID 642886669 COMMONWEALTH HEALTH ALLIA
MEDICAID 200287610B COMMONWEALTH HEALTH ALLIA
Other 611336483 COMMONWEALTH HEALTH ALLIA
Other 2435769000 COMMONWEALTH HEALTH ALLIA
Other 611336483 COMMONWEALTH HEALTH ALLIA
Other 1087687 COMMONWEALTH HEALTH ALLIA
Other 611336483 COMMONWEALTH HEALTH ALLIA
Other 000000052119 COMMONWEALTH HEALTH ALLIA
Other 2133380 COMMONWEALTH HEALTH ALLIA
Other 611336483 COMMONWEALTH HEALTH ALLIA
Other 87043 COMMONWEALTH HEALTH ALLIA

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