Provider Demographics
NPI:1134138167
Name:TRIGG, DAVID RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:RUSSELL
Last Name:TRIGG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DAVID
Other - Middle Name:RUSSELL
Other - Last Name:TRIGG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:325 BROAD ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4167
Mailing Address - Country:US
Mailing Address - Phone:803-773-5227
Mailing Address - Fax:803-753-9312
Practice Address - Street 1:325 BROAD ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150-4167
Practice Address - Country:US
Practice Address - Phone:803-773-5227
Practice Address - Fax:803-753-9312
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18211207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC18211OtherSTATE LICENSE