Individual
RONALD LEE JOHNSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4100 MAIN ST, SUITE 201, COLUMBIA, SC 29203-5800
(803) 786-0980
(803) 786-6452
Mailing address
4100 MAIN ST, SUITE 201, COLUMBIA, SC 29203-5800
(803) 786-0980
(803) 786-6452
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
10556
SC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
10556
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AT1078
—
SC
Enumeration date
07/12/2006
Last updated
10/01/2013
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