Individual
DZIANIS BUDREVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1690 SKYLYN DR STE 350, SPARTANBURG, SC 29307-1039
(864) 577-1800
(645) 771-6458
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29205
OK
208600000X
Surgery Physician
Primary
86681
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
866815
—
SC
01
—
SCL3277628
MEDICARE PIN
SC
Enumeration date
07/11/2012
Last updated
12/01/2021
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