Johnson, Mark C

Johnson, Mark C is an individual health care provider with primary practice located at 1 Childrens Pl Div Ped Cardiology, Saint Louis MO 63110-1002. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Cardiology. Allopathic & Osteopathic Physicians / Pediatric Cardiology is his primary health care specialty. Johnson, Mark C can be contacted via phone (314) 454-6095.

Contact Information

Primary practice address
1 Childrens Pl Div Ped Cardiology Saint Louis MO 63110-1002
Phone: (314) 454-6095
Fax: (314) 454-2561
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 102902 Missouri
Allopathic & Osteopathic Physicians / Pediatric Cardiology 2080P0202X 102902 Missouri

Profile Details

NPI number 1497796957
LBN Legal business name Johnson, Mark C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Apr 25th, 2024 - about 8 months 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 1497796957 NPPES
Missouri MEDICAID 206911802

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