Individual
JOHN VAUGHN FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2117 GERVAIS ST, COLUMBIA, SC 29204-1805
(803) 744-0540
Mailing address
169 LAURELHURST AVE, COLUMBIA, SC 29210-3825
(803) 733-5969
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
10102
SC
207V00000X
Obstetrics & Gynecology Physician
24590
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101026
—
SC
05
—
1528157930
—
NC
01
—
206248D
MEDICARE INDIVIDUAL PTAN LINKED TO FACULTY PRACTICE GROUP
—
01
—
31627
BLUE CROSS BLUE SHIELD
NC
Enumeration date
10/12/2006
Last updated
07/25/2023
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