| Michael Johnson, CRNA | |
|
14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | |
| (231) 547-4024 | |
| (231) 547-8088 |
| Full Name | Michael Johnson |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 14700 Lake Shore Dr, Charlevoix, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114000668 | NPI | - | NPPES |
| MJ223453 | Other | MI | BLUE SHIELD STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 4704223453 (Michigan) | Primary |
| Entity Name | Sleepsmith Staffing Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114463379 PECOS PAC ID: 8325320369 Enrollment ID: O20170126001573 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Johnson, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 Ph: (231) 547-4024 | Michael Johnson, CRNA 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 Ph: (231) 547-4024 |
Michael C Macmillan, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 12375 Indian Place Dr, Charlevoix, MI 49720 Phone: 231-547-2496 Fax: 231-547-2823 | |
Mark Leroy Vanderweide, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 | |
Jennifer L Simons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 | |
Mel Choponis, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Kenneth Forrester, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 Fax: 231-547-8088 | |
Madeline Jeakle Nemes, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 14700 Lake Shore Dr, Charlevoix, MI 49720 Phone: 231-547-4024 |