Provider Demographics
NPI:1427541515
Name:BERRY, DAVIS BRIAN (DO)
Entity type:Individual
Prefix:
First Name:DAVIS
Middle Name:BRIAN
Last Name:BERRY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 100174
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29202-3174
Mailing Address - Country:US
Mailing Address - Phone:864-512-5849
Mailing Address - Fax:864-224-0103
Practice Address - Street 1:2000 E GREENVILLE ST STE 2900
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1722
Practice Address - Country:US
Practice Address - Phone:864-512-5849
Practice Address - Fax:864-512-7575
Is Sole Proprietor?:No
Enumeration Date:2018-06-13
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91400207RG0100X
SCLL52011207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine