Individual
BRIAN SAMUEL DANTZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
46 MARKFIELD DR, SUITE A, CHARLESTON, SC 29407-6982
(843) 556-7048
(843) 556-2938
Mailing address
PO BOX 2115, SKYLAND, NC 28776-2115
(828) 575-2644
(828) 350-2174
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
007053
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070531
UNITED HEALTH CARE
SC
05
—
070531
—
SC
01
—
189320
MEDCOST
SC
01
—
B922435238
MEDICARE PTAN
SC
01
—
B922437953
MEDICARE PTAN
SC
Enumeration date
06/21/2006
Last updated
11/16/2015
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