Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | D0057842 | MD |
Y | 208600000X | Surgeon | D0057842 | MD |
N | 2086S0102X | Surgical Critical Care | D0057842 | MD |
NPI | 1336112374 |
---|---|
Provider Name | Dr. Steven B Johnson |
First Address | Phoenix, AZ 85006-2837 |
Second Address | Phoenix, AZ 85006-2837 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2006 |
Last Update Date | 14/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
777100200 | (05) | MD |