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Individual

BRANDON ROGER SICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2633 CELANESE RD, ROCK HILL, SC 29732-1205
(803) 329-5131
(803) 366-6600
Mailing address
P O BOX 602120, ROCK HILL, SC 28260-2120
(803) 329-5131
(803) 366-6600

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17450
SC
207Q00000X
Family Medicine Physician
2006-00021
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13955
BLUE CROSS BLUE SHIELD
NC
01
P00243983
RAILROAD MEDICARE
05
T13660
SC
Enumeration date
07/16/2006
Last updated
06/24/2013
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