Provider Demographics
NPI:1215914635
Name:BRUMFIELD, EDWARD SCOTT (MD)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:SCOTT
Last Name:BRUMFIELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 N FRASER ST
Mailing Address - Street 2:GEORGETOWN HEALTH GROUP
Mailing Address - City:GEORGETOWN
Mailing Address - State:SC
Mailing Address - Zip Code:29440-2848
Mailing Address - Country:US
Mailing Address - Phone:843-527-4442
Mailing Address - Fax:843-527-4027
Practice Address - Street 1:9699 OCEAN HWY
Practice Address - Street 2:GEORGETOWN HEALTH GROUP
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-7425
Practice Address - Country:US
Practice Address - Phone:843-237-4296
Practice Address - Fax:843-237-0495
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2009-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1370Medicaid
SCGP4819Medicaid
SC5078Medicare PIN
SC8938Medicare PIN