Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MAX RAY JOHNSON, MD
Active Sole ProprietorSports Medicine (Emergency) · FARGO, ND
Registration Details
- NPI Number
- 1679559975
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 19, 2005 (20.355750086749 yrs)
- Last Updated
- Jan 4, 2022
- License
-
5573 (ND)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4450 31ST AVE S STE 200FARGO, ND, 581044556Browse ND providers · Browse ZIP 58104
- Phone
- 7012939829
- Fax
- 7012930111
- Primary Specialty
-
Sports Medicine (Emergency)
207WX0107X
Other Sports Medicine (Emergency) Providers in FARGO, ND
| Name | Credential | NPI |
|---|---|---|
| MARINA GILCA | MD | 1386028314 |
| TYLER LOOYSEN | MD, MPH | 1134614381 |
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.