Brandenburg, Eric Lance

Brandenburg, Eric Lance is an sole proprietor health care provider with primary practice located at 905 Verdae Blvd Ste 101 , Greenville SC 29607-4098. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Brandenburg, Eric Lance can be contacted via phone (864) 286-7550.

Contact Information

Primary practice address
905 Verdae Blvd Ste 101 Greenville SC 29607-4098
Phone: (864) 286-7550
Fax: (864) 286-7551
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 020218 New York
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4258 South Carolina

Profile Details

NPI number 1659820835
LBN Legal business name Brandenburg, Eric Lance
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 28th, 2016
Last updated Dec 21st, 2023 - about 3 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 1659820835 NPPES
South Carolina MEDICAID 6063PA

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