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Individual

DR. BRODIE EDEN MCKOY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
851 LEONARD FULGHUM BLVD, SUITE 101, MT PLEASANT, SC 29464-3787
(843) 971-9750
(843) 971-9351
Mailing address
851 LEONARD FULGHUM DR 101, MOUNT PLEASANT, SC 29464-3793
(843) 971-9350
(843) 971-9351

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
20250
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
054413
STATE LICENSE
GA
01
20250
STATE LICENSE
SC
05
202505
SC
Enumeration date
08/13/2006
Last updated
03/07/2023
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