Provider Demographics
NPI:1679681647
Name:SAUER, SCOTT BRANNEN (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:BRANNEN
Last Name:SAUER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 VILLAGE CENTER BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29579-6707
Mailing Address - Country:US
Mailing Address - Phone:843-353-3460
Mailing Address - Fax:843-903-9032
Practice Address - Street 1:210 VILLAGE CENTER BLVD STE 150
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29579-6707
Practice Address - Country:US
Practice Address - Phone:843-353-3460
Practice Address - Fax:843-903-9032
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC516208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC606006100OtherUS DEPT.
SCDB9785OtherRR MEDICARE
SC89413OtherMEDCOST
SCGP3980Medicaid
SC005167Medicaid
NC89016NGMedicaid
NC7906288Medicaid
SCP00144797OtherRR MEDICARE
SC2020278OtherCAROLINA CARE PLAN
SC201138864OtherBCBS OF SC
SC201138864OtherBCBS OF SC
SCDB9785OtherRR MEDICARE
SCP00144797OtherRR MEDICARE
SCDB9785OtherRR MEDICARE