Individual
MICHAEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3531 MARY ADER AVE STE D, CHARLESTON, SC 29414-5896
(843) 763-4466
(843) 614-4285
Mailing address
3531 MARY ADER AVE STE D, CHARLESTON, SC 29414-5896
(843) 763-4466
(843) 614-4285
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
83627
SC
207WX0107X
Retina Specialist (Ophthalmology) Physician
83627
SC
Other
Enumeration date
06/13/2006
Last updated
05/04/2020
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