Brian James Fortman (NPI# 1063498558, PAC ID# 4284611864) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1063498558 |
| PAC ID by PECOS | 4284611864 |
| Professional Enrollment ID | I20040701000686 |
| Full Name | Brian James Fortman |
| Organization Legal Name | CAROLINA RADIOLOGY ASSOCIATES LLC |
| Address |
199 Village Ctr Blvd Suite 110 Myrtle Beach SC 29579-3589 |
| Phone Number | 8436920570 |
| Gender | M |
| Credential | MD |
| Medical School | STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE |
| Graduation Year | 1996 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 1658350764 |
| Number of Group Practice Members | 43 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 420085 | GRAND STRAND REGIONAL MEDICAL CENTER |
| 420105 | MCLEOD LORIS HOSPITAL |
| 420049 | CONWAY MEDICAL CENTER |
| 420055 | CAROLINAS HOSPITAL SYSTEM MARION |
| 420066 | LAKE CITY COMMUNITY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 199 Village Ctr Blvd, Suite 110, Myrtle Beach, SC 29579-3589 | 8436920570 | CAROLINA RADIOLOGY ASSOCIATES LLC |
| 4593 Oleander Dr, Suite 200, Myrtle Beach, SC 29577-5755 | 8436920570 | CAROLINA RADIOLOGY ASSOCIATES LLC |
| Organization Legal Name | CAROLINA RADIOLOGY ASSOCIATES LLC |
| Physicians | 50 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sarah H Allgeier | Diagnostic Radiology | Carolina Radiology Associates LLC | 1303 Azalea Ct, Suite C, Myrtle Beach, SC 29577-5765 |
| Stephan Stamato | Diagnostic Radiology | Carolina Radiology Associates LLC | 300 Singleton Ridge Rd, Conway, SC 29526-9142 |
| Geoffrey T Gilleland | Diagnostic Radiology | Carolina Radiology Associates LLC | 359 Berkeley Rd, Rock Hill, SC 29732-1997 |
| Richard J Wunder | Diagnostic Radiology | Carolina Radiology Associates LLC | 4593 Oleander Dr, Suite 200, Myrtle Beach, SC 29577-5755 |
| Scott Hagood Allen | Diagnostic Radiology | Carolina Radiology Associates LLC | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 |
| Paul M Kuperman | Diagnostic Radiology | Carolina Radiology Associates LLC | 300 Singleton Ridge Rd, Conway, SC 29526-9142 |
| Wesley Shawn Conwell | Diagnostic Radiology | Carolina Radiology Associates LLC | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 |
| Elizabeth Ann Kelley | Diagnostic Radiology | Carolina Radiology Associates LLC | 300 Singleton Ridge Rd, Conway, SC 29526-9142 |
| Joshua C Leighton | Diagnostic Radiology | Carolina Radiology Associates LLC | 805 Pamplico Hwy, Florence, SC 29505-6047 |
| Brandon Cramer | Diagnostic Radiology | Carolina Radiology Associates LLC | 300 Singleton Ridge Rd, Conway, SC 29526-9142 |
| Street Address |
199 VILLAGE CTR BLVD SUITE 110 |
| City | MYRTLE BEACH |
| State | SC |
| Zip | 29579-3589 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Renee J Flanegan | Nurse Practitioner | Atlantic Urology Clinics LLC | 199 Village Ctr Blvd, Suite 100, Myrtle Beach, SC 29579-3589 |
| Michael Rosenblum | Cardiovascular Disease (cardiology) | Grand Strand Surgical Specialists LLC | 199 Village Ctr Blvd, Suite 100, Myrtle Beach, SC 29579-3589 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Samantha A Crisafulli | Physical Therapy | Prs 7, LLC | 2140 Oakheart Rd, Myrtle Beach, SC 29579-1253 |
| Stephanie A Ferguson | Nurse Practitioner | Carolina Forest Family Medicine | 4022 Postal Way, Myrtle Beach, SC 29579-3185 |
| Lindsey T Budhoo | Nurse Practitioner | Carolina Forest Family Medicine | 4022 Postal Way, Myrtle Beach, SC 29579-3185 |
| Neal Warren Lange Jr. | Chiropractic | 4012 Postal Way, Suite A, Myrtle Beach, SC 29579-3298 | |
| Richard Nelson Eaton | Family Medicine | Doctors Care, Pa | 200 Middleburg Dr, Myrtle Beach, SC 29579-3408 |
| Ashley G Holston | Nurse Practitioner | Doctors Care, Pa | 200 Middleburg Dr, Myrtle Beach, SC 29579-3408 |
| Maria Baens | Internal Medicine | Doctors Care, Pa | 200 Middleburg Dr, Myrtle Beach, SC 29579-3408 |
| Lindsey D States | Nurse Practitioner | Doctors Care, Pa | 200 Middleburg Dr, Myrtle Beach, SC 29579-3408 |
| Penelope Anne Campbell | Family Practice | Doctors Care, Pa | 200 Middleburg Dr, Myrtle Beach, SC 29579-3408 |
| Michael Reece Cofer | Oral Surgery | Coastal Carolina Oral Maxillofacial Surgery Assoc. | 133 Towne Centre Pkwy, Myrtle Beach, SC 29579-3493 |
| Find all physicians in zip 29579 | |||
| City | MYRTLE BEACH |
| Zip Code | 29579 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | MYRTLE BEACH + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Brian James Fortman.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.