Provider Demographics
NPI:1801810007
Name:ADLER, BRIAN KEITH (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:KEITH
Last Name:ADLER
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:PO BOX 14690
Mailing Address - Street 2:
Mailing Address - City:SURFSIDE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29587-4690
Mailing Address - Country:US
Mailing Address - Phone:843-314-1357
Mailing Address - Fax:854-212-7381
Practice Address - Street 1:5046 HIGHWAY 17 BYP S STE 205
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29588-4503
Practice Address - Country:US
Practice Address - Phone:843-314-1357
Practice Address - Fax:854-212-7381
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11949207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP0439Medicaid
SCGP0439Medicaid
SCD17557Medicare UPIN