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NPI Code Detail

MEDICARE: DARRYL JON BRUSH M.D.

MEDICARE: DARRYL JON BRUSH M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician35-069943OH
22084P0800XPsychiatry Physician83842SC

General Provider Information

NPI Number : 1689773418
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARRYL JON BRUSH M.D.
Provider Business Mailing Address
First Line : 1670 UPHAM DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43210-1250
Country : US
Telephone Number : 614-293-9600
Fax Number : 614-293-4200
Provider Business Practice Location Address
First Line : 10 PATEWOOD DR STE 130
Second Line :
City : GREENVILLE
State : SC
Zip : 29615-6317
Country : US
Telephone Number : 864-522-5550
Fax Number : 864-522-5555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 08/15/2019

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