person
Brian Glenn Widenhouse, MD
Plastic and Reconstructive Surgery Physician in North Charleston, South Carolina
NPI 1265481543

Brian Glenn Widenhouse is a Plastic and Reconstructive Surgery Physician based in North Charleston, SC and is specialized in Plastic and Reconstructive Surgery. Brian Glenn Widenhouse practices in North Charleston, SC and has the professional credentials of MD. The NPI Number for Brian Glenn Widenhouse is 1265481543 and holds a License No. 20096 (South Carolina).

The current practice location address for Brian Glenn Widenhouse is 2683 Lake Park Dr, North Charleston, SC and can be reached out via phone at 843-518-5000 and via fax at 843-614-8959. You can also correspond with Brian Glenn Widenhouse through the mailing address at 2683 LAKE PARK DR, NORTH CHARLESTON, SC - 29406-9100 (mailing address contact number: 843-518-5000).

Location: 2683 Lake Park Dr, North Charleston, SC, 29406-9100
person
Provider Profile Details
NPI Number
1265481543
Provider Name
Brian Glenn Widenhouse
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2683 Lake Park Dr, North Charleston, SC, 29406-9100
Phone Number
843-518-5000
Fax Number
843-614-8959
Provider Enumeration Date
05/06/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200963 05 SC
institution
Provider Business Practice Location Address Details
Address
2683 Lake Park Dr
City
State
Zip
29406-9100
Phone Number
843-518-5000
Fax Number
843-614-8959
person
Provider Business Mailing Address Details
Address
2683 Lake Park Dr
City
State
Zip
29406-9100
Phone Number
843-518-5000
Fax Number
843-614-8959
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Plastic and Reconstructive Surgery
Taxonomy
License No.
20096 (South Carolina)
Definition
A surgeon who specializes in plastic and reconstructive surgery.
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