NPI 1275612624

Mark Herbert Johnson, MD

Practitioner Legal Medicine Minneapolis, MN

Practice location

Address: 2104 Oliver Ave S, Minneapolis, MN 55405-2437
Phone: (612) 377-6084

Registered specialties

Legal Medicine Primary

Other Service Providers Taxonomy 173000000X Licence 19187 (MN)

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Registry record

NPI: 1275612624
Entity type: Individual
Sex (as registered): Male
NPI issued: 6 Nov 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.