IndividualActive
Mary Ida Johnson, MD
NPI 1184630832 · Neurology with Special Qualifications in Child Neurology Physician · Albuquerque, NM
Provider details
- NPI number
- 1184630832
- Entity type
- Individual
- Primary specialty
- Neurology with Special Qualifications in Child Neurology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- License
- 2000-214 (NM)
Specialties & taxonomies
- Neurology with Special Qualifications in Child Neurology PhysicianPrimary2084N0402XLicense 2000-214 (NM)
Allopathic & Osteopathic Physicians
Practice location
2nd Ambulatory Care Ctr
2211 Lomas Blvd. Ne
Albuquerque, NM 87131-0001
Phone: (505) 272-3342
Approximate (ZIP-level) locationGet directions
Mailing address
2211 Lomas Blvd Ne
Albuquerque, NM 87131-0001
Registry dates
- Enumerated
- 2006-08-01
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.