Johnson, Edward R

Johnson, Edward R is an individual health care provider with primary practice located at 3000 32Nd Ave S , Fargo ND 58103-6132. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. Johnson, Edward R can be contacted via phone (701) 364-8000.

Contact Information

Primary practice address
3000 32Nd Ave S Fargo ND 58103-6132
Phone: (701) 364-8000
Fax: (701) 364-8078
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 10858 North Dakota
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X 42197 Minnesota

Profile Details

NPI number 1497715064
LBN Legal business name Johnson, Edward R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2006
Last updated Nov 4th, 2008 - about 16 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 1497715064 NPPES
North Dakota MEDICAID 14696
North Dakota MEDICAID 968613400

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