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1265481543
BRIAN GLENN WIDENHOUSE
NORTH CHARLESTON, SC
NPI
1265481543
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: SC 20096)
Enumeration Date
2006-05-06
Last Update Date
2017-04-03
Business Address
-- BRIAN GLENN WIDENHOUSE m.d.
2683 LAKE PARK DR
NORTH CHARLESTON, SC 29406-9100
Phone number: 843-518-5000
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Mailing Address
-- BRIAN GLENN WIDENHOUSE m.d.
2683 LAKE PARK DR
NORTH CHARLESTON, SC 29406-9100
Phone number: 843-518-5000
Copy
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