Johenk, Paul David
Johenk, Paul David is an individual health care provider with primary practice located at Us Hwy 491 North , Shiprock NM 87420. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Johenk, Paul David can be contacted via phone (505) 368-6401.Contact Information
Primary practice address
Us Hwy 491 North
Shiprock NM 87420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 20A4190 | California |
Profile Details
| NPI number | 1366430084 |
|---|---|
| LBN Legal business name | Johenk, Paul David |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 6th, 2005 |
| Last updated | Dec 26th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366430084 | NPPES |
| Colorado | MEDICAID | 41639529 | |
| Colorado | MEDICAID | B3824 | |
| Colorado | MEDICAID | 696388 |
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