Organization
HILTON HEAD SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN N ANDERSON MD (PRESIDENT)
(843) 689-9720
Entity
Organization
Contact information
Practice address
22 BETHEA DR, HILTON HEAD ISLAND, SC 29926-4702
(843) 689-9720
(843) 689-9704
Mailing address
PO BOX 23613, HILTON HEAD ISLAND, SC 29925-3613
(843) 689-9720
(843) 689-9704
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
16696
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6953
MEDICARE GROUP NUMBER
SC
05
—
GP2936
—
SC
Enumeration date
11/02/2005
Last updated
04/20/2008
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