Provider Demographics
NPI:1801805270
Name:JOHNSON, AMOS CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:AMOS
Middle Name:CHARLES
Last Name:JOHNSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:29877 TELEGRAPH RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-7660
Mailing Address - Country:US
Mailing Address - Phone:248-827-4322
Mailing Address - Fax:248-827-7822
Practice Address - Street 1:29877 TELEGRAPH RD STE 300
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-7660
Practice Address - Country:US
Practice Address - Phone:248-827-4322
Practice Address - Fax:248-827-7822
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAJ051658207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine