Individual
DR. BRIAN KEITH RUNDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
890 W FARIS RD STE 320, GREENVILLE, SC 29605-4281
(864) 455-1200
(864) 455-1209
Mailing address
300 E MCBEE AVE STE 401, GREENVILLE, SC 29601-2842
(864) 522-8602
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
307379
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
83753
SC
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
DO-04423
IA
Other
Enumeration date
07/17/2006
Last updated
11/10/2021
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