Provider Demographics
NPI:1033182399
Name:BRILL, ALAN HOWARD (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:HOWARD
Last Name:BRILL
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 1:3 RICHLAND MEDICAL PARK
Mailing Address - Street 2:SUITE 130
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6850
Mailing Address - Country:US
Mailing Address - Phone:803-744-7770
Mailing Address - Fax:803-744-7776
Practice Address - Street 1:3 RICHLAND MEDICAL PARK
Practice Address - Street 2:SUITE 130
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6850
Practice Address - Country:US
Practice Address - Phone:803-744-7770
Practice Address - Fax:803-744-7776
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8115207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC081155Medicaid
SC081155Medicaid