| Doctor Name: | ERIC MICHAEL JOHNSON |
| NPI Number: | 1750694964 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 4301097327 |
| Business Practice Address: | 1000 Monroe Ave Nw Suite 2200 Grand Rapids, MI - 495031455 |
| Business Phone Number: | 6163913245 |
| Business Fax Number: | |
| Mailing Address: | 1000 Monroe Ave Nw, Suite 2200 GRAND RAPIDS |
| State: | MI |
| Postal Code: | 495031455 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 07/16/2010 |
| NPI Last Update Date: | 07/16/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 4301097327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |