NPI 1699224931

Charles Wade Johnson, PAC

Practitioner Physician Assistant Fort Meade, SD

Practice location

Address: 113 Comanche Rd, Fort Meade, SD 57741-1002
Phone: (605) 347-7491

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

Other Physician Assistant providers in South Dakota →

Registry record

NPI: 1699224931
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Sep 2016
Record last updated: 28 Sep 2016

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.