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Contact Information

DEREK B JOHNSON, MD
454 SAINT MICHAELS DR STE 200
SANTA FE, NM87505
 Phone: 505-303-5000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for DEREK B JOHNSON · (Male)

NPI Number 1912944661
Status Active
Credentials MD
Entity Individual
Enumeration date 06/01/2006
Last updated 08/28/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • MA License # 224930
  • NM License # MD2018-0748
  • WI License # 49065
  • WI Medicaid 34863900
  • WI Other 057945003 MEDICARE PTAN
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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