Individual
DONOVAN WHITNEY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8004 MYRTLE TRACE DRIVE, SUITE 200, CONWAY, SC 29526-8945
(843) 347-8041
(843) 347-8042
Mailing address
300 SINGLETON RIDGE RD, ATTENTION CREDENTIALING, CONWAY, SC 29526-9142
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
86405
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
864050
—
SC
Enumeration date
06/05/2015
Last updated
11/21/2025
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