Individual
MR. BRIAN M HEASTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 CASHUA ST, DARLINGTON, SC 29532-3301
(843) 393-7452
(843) 393-6310
Mailing address
3400 WEST AVE, COLUMBIA, SC 29203-6901
(803) 254-3676
(803) 254-3678
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
18825
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
188255
—
SC
Enumeration date
11/14/2005
Last updated
11/26/2007
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