Brian J Fortman MD

NPI 1063498558 - Radiology - 2085R0204X

NPI Details
NPI 1063498558
Gender Male
Enumeration Date 12/16/2005
Last Updated 11/22/2013
Entity Type Individual
Active Over 10 years ago
Practice Location
300 SINGLETON RIDGE RD
CONWAY SC, 29526-9142, US
Phone (843) 238-8660
Fax
Business Location
PO BOX 51030
MYRTLE BEACH SC, 29579-0018, US
Phone (843) 238-8660
Fax
Toxanomy
Taxonomy Code 2085R0204X
License State South Carolina
License Number 23111
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According to our database, Brian J Fortman MD NPI is 1063498558, taxonomy code is 2085R0204X and license number is 23111, license state is located at South Carolina. Brian J Fortman MD physically located at 300 Singleton Ridge Rd, Conway SC, 29526-9142. NPI Number Brian J Fortman MD has the Individual type.

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1063498558 NPI number is provided on an as is basis without warranty of any kind. 1063498558 is maintained by the National Plan & Provider Enumeration System. The contents of Brian J Fortman MD are for informational purposes only.