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Individual

BRIAN A BLUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
901 W MEETING ST, SUITE 104, LANCASTER, SC 29720-6219
(803) 285-3700
(803) 285-3715
Mailing address
901 W MEETING ST, SUITE 104, LANCASTER, SC 29720-6219
(803) 285-3700
(803) 285-3715

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16798
SC
207X00000X
Orthopaedic Surgery Physician
9901507
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01196446
AMERIGROUP
SC
01
4457436
AETNA
SC
01
571029311005
BCBS
SC
01
571029311006
BCBS
SC
05
8912370
NC
01
904051
PPNI
SC
01
9921493
CIGNA
SC
05
TL8382
SC
Enumeration date
01/11/2006
Last updated
09/28/2012
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