Johnson, Michael Joel

Johnson, Michael Joel is an individual health care provider with primary practice located at 3900 Park Nicollet Blvd , St Louis Park MN 55416-2505. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Johnson, Michael Joel can be contacted via phone (952) 993-3150.

Contact Information

Primary practice address
3900 Park Nicollet Blvd St Louis Park MN 55416-2505
Phone: (952) 993-3150
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2818 Minnesota

Profile Details

NPI number 1780710459
LBN Legal business name Johnson, Michael Joel
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 26th, 2007
Last updated Feb 4th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780710459 NPPES
Minnesota Other 531P4JO BCBS
Minnesota Other OP6854 BCBS
Minnesota Other HP64503 BCBS
Minnesota Other 133059 BCBS
Minnesota Other 22-03338 BCBS
Minnesota Other A01991033717 BCBS

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