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General NPI Number Information
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NPI Number | 1942293857
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Entity Type | Individual
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Provider Name | BEULAH M. BROOKS DPM
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Gender | Female
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Dates
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Enumeration Date | 08/25/2005
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 172 SPRING ST
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City | CHARLESTON
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State | SC
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Zip | 29403-5220
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Country | US
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Telephone | 843-722-8628
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Fax | 843-722-1055
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Provider Business Mailing Address
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Address Line | PO BOX 1633
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City | WALTERBORO
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State | SC
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Zip | 29488-0016
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Country | US
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Telephone | 843-549-6271
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Fax | 843-542-9030
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 123
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License Number State | SC
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