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1013960269
GREG R JOHNSON
FORT WAYNE, IN
NPI
1013960269
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RN0300X Internal Medicine, Nephrology
(Licence: IN 02001531A)
Enumeration Date
2006-05-18
Last Update Date
2022-12-21
Business Address
GREG R JOHNSON DO
3909 NEW VISION DR
FORT WAYNE, IN 46845-1725
Phone number: 260-469-6602
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Mailing Address
GREG R JOHNSON DO
11109 PARKVIEW PLAZA DR # 117
FORT WAYNE, IN 46845-1701
Phone number:
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