Healthcare Provider Details

I. General information

NPI: 1245387083
Provider Name (Legal Business Name): BRIAN M ELIAS DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 WILLOW GROVE WAY
PIEDMONT SC
29673-7017
US

IV. Provider business mailing address

207 WILLOW GROVE WAY
PIEDMONT SC
29673-7017
US

V. Phone/Fax

Practice location:
  • Phone: 814-771-9960
  • Fax:
Mailing address:
  • Phone: 814-771-9960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberSC004352L
License Number StatePA

VIII. Authorized Official

Name: DR. BRIAN M ELIAS
Title or Position: PODIATRIST OWNER
Credential: DPM
Phone: 814-771-9960