Healthcare Provider Details

I. General information

NPI: 1841855426
Provider Name (Legal Business Name): BRINDA DHIRUBHAI BASIDA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2019
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date: 12/16/2019
Reactivation Date: 01/09/2020

III. Provider practice location address

2 MEDICAL PARK RD STE 501
COLUMBIA SC
29203-6839
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-3320
  • Fax: 803-933-3036
Mailing address:
  • Phone: 864-695-6697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number94124
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: