Johnson, David Martin
Johnson, David Martin is an individual health care provider with primary practice located at 2300 N Edward Str , Decatur IL 62526. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Johnson, David Martin can be contacted via phone (217) 876-5021.Contact Information
Primary practice address
2300 N Edward Str
Decatur IL 62526
Phone: (217) 876-5021
Fax: (217) 876-5013
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | Illinois |
Profile Details
| NPI number | 1922014455 |
|---|---|
| LBN Legal business name | Johnson, David Martin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 1st, 2006 |
| Last updated | Jul 8th, 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 | 1922014455 | NPPES |
| Illinois | MEDICAID | 0360580891 |
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