Provider Demographics
NPI:1922028109
Name:PRICE, ANNA BRUNSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:BRUNSON
Last Name:PRICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 306
Mailing Address - Street 2:106 CAUSEWAY DR
Mailing Address - City:BOWMAN
Mailing Address - State:SC
Mailing Address - Zip Code:29018-0306
Mailing Address - Country:US
Mailing Address - Phone:803-829-2523
Mailing Address - Fax:803-829-3369
Practice Address - Street 1:106 CAUSEWAY DR
Practice Address - Street 2:
Practice Address - City:BOWMAN
Practice Address - State:SC
Practice Address - Zip Code:29018-0306
Practice Address - Country:US
Practice Address - Phone:803-829-2523
Practice Address - Fax:803-829-3369
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14255208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCC04293Medicare UPIN