Individual
DR. JOHNNY C WEEKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2075 EAGLE LANDING BLVD, N CHARLESTON, SC 29406-4074
(843) 797-5747
(843) 797-0857
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16744
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16744
STATE LICENSE
SC
05
—
167447
—
SC
01
—
5551
MEDICARE GROUP #
SC
01
—
GP4910
MEDICAID GROUP #
SC
01
—
P00638295
RAILROAD MEDICARE
SC
Enumeration date
03/11/2007
Last updated
10/29/2020
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