MEDICARE: DR. BRIAN KEITH ADLER MD

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
1	207R00000X	Internal Medicine Physician	11949	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801810007
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN KEITH ADLER MD

Provider Business Mailing Address
First Line	:	PO BOX 14690
Second Line	:
City	:	SURFSIDE BEACH
State	:	SC
Zip	:	29587-4690
Country	:	US
Telephone Number	:	843-314-1357
Fax Number	:	854-212-7381

Provider Business Practice Location Address
First Line	:	5046 HIGHWAY 17 BYP S STE 205
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-4503
Country	:	US
Telephone Number	:	843-314-1357
Fax Number	:	854-212-7381

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	08/27/2025

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