Charles Wade Johnson, PA-C
NPI #1699224931 in Fort Meade, South Dakota
Provider Information
- NPI Number
- 1699224931
- Entity Type
- Individual
- Name
- Charles Wade Johnson, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Sep 28, 2016
- Last Updated
- Sep 28, 2016
Practice Location
- Address
- 113 COMANCHE RD
- City
- Fort Meade
- State
- South Dakota
- ZIP Code
- 57741-1002
- Phone
- (605) 347-7491
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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