Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 8115 | SC |
NPI | 1033182399 |
---|---|
Provider Name | Alan Howard Brill |
First Address | Columbia, SC 29203-6850 |
Second Address | Columbia, SC 29203-6850 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 03/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
081155 | (05) | SC |