Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Other names
James H. Brunson, Jr, MD
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DANDRIDGE (PRESIDENT)
(803) 395-2200
Entity
Organization
Contact information
Practice address
1170 BOULEVARD ST, SUITE A, ORANGEBURG, SC 29115-4359
(803) 533-0042
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4499
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4350
—
SC
Enumeration date
06/03/2006
Last updated
08/22/2020
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