Provider Demographics
NPI:1063680924
Name:JOHNSON, DAVID RUE (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RUE
Last Name:JOHNSON
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Gender:M
Credentials:MD, MPH
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Other - First Name:
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Mailing Address - Street 1:SANOFI PASTEUR
Mailing Address - Street 2:ONE DISCOVERY DRIVE, BUILDING 60
Mailing Address - City:SWIFTWATER
Mailing Address - State:PA
Mailing Address - Zip Code:18370-9100
Mailing Address - Country:US
Mailing Address - Phone:570-957-1506
Mailing Address - Fax:866-322-0596
Practice Address - Street 1:SANOFI PASTEUR
Practice Address - Street 2:ONE DISCOVERY DRIVE
Practice Address - City:SWIFTWATER
Practice Address - State:PA
Practice Address - Zip Code:18370-9100
Practice Address - Country:US
Practice Address - Phone:570-957-1506
Practice Address - Fax:866-322-0596
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD423917208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics