Individual
BRIAN WAYNE DACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
727 SE MAIN ST STE 130, SIMPSONVILLE, SC 29681-3266
(864) 454-6560
(864) 454-6565
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6303
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
747
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007478
—
SC
01
—
576007863132
BLUE CHOICE OF SC
SC
01
—
576007863173
BCBS OF SC
SC
01
—
P00322763
RR MEDICARE
SC
Enumeration date
06/06/2006
Last updated
03/17/2018
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