Individual
DANIEL WALTER BRAKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
124 VERDAE BLVD STE 204, GREENVILLE, SC 29607-3844
(864) 315-1300
(864) 315-1301
Mailing address
124 VERDAE BLVD STE 204, GREENVILLE, SC 29607-3844
(864) 315-1300
(864) 315-1301
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23655
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236550
—
SC
01
—
7602457
AETNA
SC
01
—
P00038952
RR MEDICARE
SC
Enumeration date
06/07/2006
Last updated
02/10/2026
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