Mckoy, Brodie Eden

Mckoy, Brodie Eden is an individual health care provider with primary practice located at 851 Leonard Fulghum Blvd Suite 101, Mt Pleasant SC 29464-3787. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Mckoy, Brodie Eden can be contacted via phone (843) 971-9750.

Contact Information

Primary practice address
851 Leonard Fulghum Blvd Suite 101 Mt Pleasant SC 29464-3787
Phone: (843) 971-9750
Fax: (843) 971-9351
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 20250 South Carolina

Profile Details

NPI number 1598777864
LBN Legal business name Mckoy, Brodie Eden
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 13th, 2006
Last updated Mar 7th, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598777864 NPPES
South Carolina Other 20250 STATE LICENSE
South Carolina Other 054413 STATE LICENSE
South Carolina MEDICAID 202505 STATE LICENSE

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