Johnson, Eric Matthew

Johnson, Eric Matthew is an individual health care provider with primary practice located at 2545 Chicago Ave Suite 601, Minneapolis MN 55404-4522. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Johnson, Eric Matthew can be contacted via phone (612) 863-7770.

Contact Information

Primary practice address
2545 Chicago Ave Suite 601 Minneapolis MN 55404-4522
Phone: (612) 863-7770
Fax: (612) 863-7772
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36808 Minnesota

Profile Details

NPI number 1811949498
LBN Legal business name Johnson, Eric Matthew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Sep 12th, 2012 - about 12 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 1811949498 NPPES
Minnesota Other 07D69JO BLUE CROSS BLUE SHIELD
Minnesota Other 32072100 BLUE CROSS BLUE SHIELD
Minnesota Other HP28250 BLUE CROSS BLUE SHIELD
Minnesota Other 107252D417 BLUE CROSS BLUE SHIELD
Minnesota Other 1711761 BLUE CROSS BLUE SHIELD
Minnesota MEDICAID 845718200 BLUE CROSS BLUE SHIELD

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