DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. SHAE HAL JOHNSON, DO

Active Sole Proprietor

DR. SHAE HAL JOHNSON, DO is a Family Medicine healthcare provider located in BOISE, Idaho. NPI 1669588315 is currently active in the NPPES registry. Verify at CMS.

Family Medicine · BOISE, ID

Registration Details

NPI Number
1669588315
Provider Type
Individual
Gender
Male
NPI Issued
Aug 22, 2006 (19.961665667404 yrs)
Last Updated
Nov 10, 2016
Licenses
5960250-1204 (UT)
DO27594 (OR)
O-0870 (ID)
Sole Proprietor
Yes

Practice Information

Address
6533 EMERALD STREET
BOISE, ID, 837048737
Browse ID providers · Browse ZIP 83704
Phone
2083025100
Fax
2083025155
Primary Specialty
Family Medicine
207Q00000X
Additional Specialty
Family Medicine
Additional Specialty
Family Medicine

Other Family Medicine Providers in BOISE, ID

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.