Individual
DR. BRANDI L DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7033 SAINT ANDREWS RD STE 305, COLUMBIA, SC 29212-1181
(803) 779-3378
(803) 779-3103
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35179
SC
207R00000X
Internal Medicine Physician
68741
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1883689
—
LA
Enumeration date
05/21/2009
Last updated
10/27/2020
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