Michael W Johnson, MD, PC

Organization Active NPI Surgery Physician · Saint Ignace, MI

NPI 1992887202 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1992887202
Entity type
Organization (NPI type 2)
Primary specialty
Surgery Physician 208600000X
License
4301054807 (MI)
Legal business name
MICHAEL W JOHNSON, MD, PC
Practice address
220 Burdette St
Saint Ignace, MI 49781-1712
Phone
(906) 643-0466
NPI assigned
Oct 19, 2006
Organization subpart
No

Authorized official

Name
Tina Bays
Title
Office Manager
Phone
(231) 487-1000

National Provider Directory

Locations

101 W Mitchell St
Petoskey, MI 49770
Phone (231) 487-1000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208600000X 4301054807 MI Yes

Addresses

Primary practice location

220 Burdette St
Saint Ignace, MI 49781-1712

Mailing address

101 W Mitchell St
Petoskey, MI 49770-2323
Phone (231) 487-1000

Other identifiers

IdentifierTypeStateIssuer
4301054807OtherMISTATE LICENSE
21407OtherMIMOLINA
0202410071OtherMIBCBSM PROVIDER ID#

Other providers in Saint Ignace, MI

All providers in Saint Ignace, MI · Surgery Physician in Michigan

Sources for this page

Verify at the official NPI Registry.