Johnson, Michael Anthony

Johnson, Michael Anthony is an sole proprietor health care provider with primary practice located at 24 Mallard Ct , Beckley WV 25801-3664. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Psychiatry, which is considered as his primary health care specialty. Johnson, Michael Anthony can be contacted via phone (304) 252-8409.

Contact Information

Primary practice address
24 Mallard Ct Beckley WV 25801-3664
Phone: (304) 252-8409
Fax: (304) 252-0022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X DP00939097 West Virginia

Profile Details

NPI number 1588640700
LBN Legal business name Johnson, Michael Anthony
Credentials MSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2005
Last updated Jul 7th, 2011 - about 13 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 1588640700 NPPES
West Virginia MEDICAID 0116688000

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