Individual
BRIAN K BLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3545 HIGHWAY 17, SUITE 200, MURRELLS INLET, SC 29576-5113
(843) 294-1941
(843) 294-0597
Mailing address
210 VILLAGE CENTER BLVD STE 140, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
(843) 353-3461
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
29468
SC
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
29468
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000245124
UNISON
SC
01
—
053
BLUE CHOICE
SC
01
—
055
BCBS
SC
01
—
18500
EVOLUTIONS
SC
01
—
208805
MEDCOST
SC
05
—
294684
—
SC
01
—
5909643
NC MEDICAID
NC
01
—
9956198
AETNA
SC
01
—
AA19548552
MEDICAREPTAN
SC
Enumeration date
04/11/2007
Last updated
07/20/2022
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