Healthcare Provider Details

I. General information

NPI: 1780633693
Provider Name (Legal Business Name): DOUGLAS WHITTED BRASH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2006
Last Update Date: 10/13/2025
Certification Date: 10/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 BARNWELL HWY
DENMARK SC
29042-9410
US

IV. Provider business mailing address

PO BOX 23321
NEW YORK NY
10087-3321
US

V. Phone/Fax

Practice location:
  • Phone: 803-395-3352
  • Fax:
Mailing address:
  • Phone: 843-792-6200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number1591
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: