Healthcare Provider Details

I. General information

NPI: 1679681647
Provider Name (Legal Business Name): SCOTT BRANNEN SAUER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2006
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 VILLAGE CENTER BLVD STE 150
MYRTLE BEACH SC
29579-6707
US

IV. Provider business mailing address

210 VILLAGE CENTER BLVD STE 150
MYRTLE BEACH SC
29579-6707
US

V. Phone/Fax

Practice location:
  • Phone: 843-353-3460
  • Fax: 843-903-9032
Mailing address:
  • Phone: 843-353-3460
  • Fax: 843-903-9032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number516
License Number StateSC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: