Provider Demographics
NPI:1528092673
Name:BRILL, PAUL A (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:A
Last Name:BRILL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:PAUL
Other - Middle Name:A
Other - Last Name:BRILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
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:864-512-7636
Mailing Address - Fax:864-512-3641
Practice Address - Street 1:2000 E GREENVILLE ST
Practice Address - Street 2:SUITE 2800
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1580
Practice Address - Country:US
Practice Address - Phone:864-512-7636
Practice Address - Fax:864-512-3641
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC201152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC201151Medicaid
SCP01250058OtherRR MEDICARE
SCP01250058OtherRR MEDICARE
SC2083Medicare PIN
SCAA83737111Medicare PIN