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Individual

DR. BEULAH M. BROOKS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPM

Contact information

Practice address
172 SPRING ST, CHARLESTON, SC 29403-5220
(843) 722-8628
(843) 722-1055
Mailing address
PO BOX 1633, WALTERBORO, SC 29488-0016
(843) 549-6271
(843) 542-9030

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
123
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
480015086
RAILROAD MEDICARE
SC
01
84899
MEDCOST
SC
01
9638584
GHI
SC
05
DE1790
SC
01
P00374130
RAILROAD MEDICARE
SC
05
PD1233
SC
01
S346000
CIGNA HEALTHCARE
SC
Enumeration date
08/25/2005
Last updated
12/14/2007
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