Individual
BRIAN GLENN WIDENHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2683 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
(843) 518-5000
(843) 614-8959
Mailing address
2683 LAKE PARK DR, NORTH CHARLESTON, SC 29406-9100
(843) 518-5000
(843) 614-8959
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
20096
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200963
—
SC
Enumeration date
05/06/2006
Last updated
04/03/2017
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us