Provider Demographics
NPI:1619902905
Name:ERNST, JOHN MJ (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:MJ
Last Name:ERNST
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-958-2500
Mailing Address - Fax:843-958-2680
Practice Address - Street 1:2093 HENRY TECKLENBURG DR STE 200E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5742
Practice Address - Country:US
Practice Address - Phone:843-958-2500
Practice Address - Fax:843-958-2680
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2022-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11777207XS0106X, 207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00614933OtherRAILROAD MEDICARE
SC117778Medicaid
SCP00727260OtherRAILROAD MEDICARE ID-RSFPN
SCD803569223Medicare PIN
SCP00727260OtherRAILROAD MEDICARE ID-RSFPN
SC117778Medicaid