Provider Demographics
NPI:1457435810
Name:JOHNSON, DAVID ROBERT (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROBERT
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:116A
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-467-1762
Mailing Address - Fax:612-727-5633
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:116A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-1762
Practice Address - Fax:612-727-5633
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN386232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry