Individual
DR. TERRY D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2550 ELMS CENTER RD, NORTH CHARLESTON, SC 29406-9844
(843) 302-8840
(843) 818-2188
Mailing address
201 SIGMA DR, STE 100, SUMMERVILLE, SC 29486-7715
(843) 793-5970
(843) 818-2187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7353
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
073538
—
SC
01
—
080075168
RR MCR
—
01
—
P00829107
RAILROAD MEDICARE ID
SC
Enumeration date
01/03/2006
Last updated
12/04/2017
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