Brisson, Theodore Edward
Brisson, Theodore Edward is an individual health care provider with primary practice located at 2890 Tricom Street , North Charleston SC 29406-9171. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Brisson, Theodore Edward can be contacted via phone (843) 797-6600.Contact Information
Primary practice address
2890 Tricom Street
North Charleston SC 29406-9171
Phone: (843) 797-6600
Fax: (843) 820-1440
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | ME90953 | Florida |
| Allopathic & Osteopathic Physicians / Urology | 208800000X | 30581 | South Carolina |
Profile Details
| NPI number | 1699759563 |
|---|---|
| LBN Legal business name | Brisson, Theodore Edward |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Apr 17th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699759563 | NPPES |
| South Carolina | Other | 7026 | MEDICARE GROUP |
| South Carolina | MEDICAID | GP4871 | MEDICARE GROUP |
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