Provider Demographics
NPI:1841855426
Name:BASIDA, BRINDA DHIRUBHAI (MD)
Entity type:Individual
Prefix:
First Name:BRINDA
Middle Name:DHIRUBHAI
Last Name:BASIDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:2 MEDICAL PARK RD STE 501
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6839
Practice Address - Country:US
Practice Address - Phone:803-434-3320
Practice Address - Fax:803-933-3036
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2025-09-22
Deactivation Date:2019-12-16
Deactivation Code:
Reactivation Date:2020-01-09
Provider Licenses
StateLicense IDTaxonomies
SC94124207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology