Johnson, Matthew Sander

Johnson, Matthew Sander is an individual health care provider with primary practice located at 3777 Coon Rapids Blvd Nw Suite 100, Coon Rapids MN 55433. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Johnson, Matthew Sander can be contacted via phone (763) 421-7420.

Contact Information

Primary practice address
3777 Coon Rapids Blvd Nw Suite 100 Coon Rapids MN 55433
Phone: (763) 421-7420
Fax: (763) 592-8453
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 20373 Minnesota
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 28337 Oklahoma

Profile Details

NPI number 1558593004
LBN Legal business name Johnson, Matthew Sander
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 18th, 2009
Last updated Jul 31st, 2013 - 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 1558593004 NPPES
Minnesota Other 20373 RESIDENCY PERMIT NUMBER

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