| Julie K Johnson, DO | |
| 
					1105 6th St, Traverse City, MI 49684-2349  | |
| (231) 947-0673 | |
| (801) 740-2847 | 
| Full Name | Julie K Johnson | 
|---|---|
| Gender | Female | 
| Speciality | Emergency Medicine - Emergency Medical Services | 
| Location | 1105 6th St, Traverse City, Michigan | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1497751929 | NPI | - | NPPES | 
| 930018880 | Other | MI | RAILROAD MEDICARE | 
| 3064262 | Medicaid | MI | |
| JJ011139 | Other | MI | BLUE CROSS BLUE SHIELD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207PE0004X | Emergency Medicine - Emergency Medical Services | 5101011139 (Michigan) | Primary | 
| Entity Name | Northwestern Michigan Emergency Physicians Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1073597944 PECOS PAC ID: 7214933928 Enrollment ID: O20061019000359  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Julie K Johnson, DO 4624 N Spider Lake Rd, Traverse City, MI 49696-8440 Ph: (231) 947-0673  | Julie K Johnson, DO 1105 6th St, Traverse City, MI 49684-2349 Ph: (231) 947-0673  | 
Bevin Clayton, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
Dale C Blum, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
Dr. Brandi Jenks Gunn, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
Richard G Faller, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673 Fax: 801-740-2847  | |
David Darwin Nicolaou, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 550 Munson Ave, Traverse City, MI 49686 Phone: 231-935-8710  | |
David Shapiro, DO Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1105 Sixth St, Traverse City, MI 49684 Phone: 231-395-6333 Fax: 801-740-2847  | |
Juhn Mark Han,  Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1105 6th St, Traverse City, MI 49684 Phone: 231-947-0673  |