Provider Demographics
NPI:1396805354
Name:SCHWARTZBERG, BRIAN JEFFREY (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:JEFFREY
Last Name:SCHWARTZBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50520
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-0520
Mailing Address - Country:US
Mailing Address - Phone:843-552-4240
Mailing Address - Fax:843-552-4121
Practice Address - Street 1:1101 BOWMAN RD
Practice Address - Street 2:
Practice Address - City:MT. PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3213
Practice Address - Country:US
Practice Address - Phone:843-284-4911
Practice Address - Fax:843-284-4910
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26658207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC266580Medicaid
SC218785071OtherTRICARE
SC20046467OtherSELECT HEALTH
SC185707OtherMEDCOST
SC218785071OtherTRICARE
SCI11300Medicare UPIN