1063680924 NPI number — DR. DAVID RUE JOHNSON MD, MPH

Table of content: DR. DAVID RUE JOHNSON MD, MPH (NPI 1063680924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063680924 NPI number — DR. DAVID RUE JOHNSON MD, MPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
DAVID
Provider Middle Name:
RUE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1063680924
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SANOFI PASTEUR
Provider Second Line Business Mailing Address:
ONE DISCOVERY DRIVE, BUILDING 60
Provider Business Mailing Address City Name:
SWIFTWATER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18370-9100
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-957-1506
Provider Business Mailing Address Fax Number:
866-322-0596

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SANOFI PASTEUR
Provider Second Line Business Practice Location Address:
ONE DISCOVERY DRIVE
Provider Business Practice Location Address City Name:
SWIFTWATER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18370-9100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-957-1506
Provider Business Practice Location Address Fax Number:
866-322-0596
Provider Enumeration Date:
02/13/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD423917 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com