Individual
CRYSTAL Y. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
233 LONGTOWN RD, COLUMBIA, SC 29229-8550
(803) 788-0268
(803) 788-7384
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
27811
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
27811
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278112
—
SC
Enumeration date
05/05/2006
Last updated
11/09/2020
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