Provider Demographics
NPI:1871857896
Name:CONGDON, BRITTNEY (MD)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:
Last Name:CONGDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BRITTNEY
Other - Middle Name:
Other - Last Name:BECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1131 SALUDA ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5776
Mailing Address - Country:US
Mailing Address - Phone:803-325-7744
Mailing Address - Fax:
Practice Address - Street 1:1131 SALUDA ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5776
Practice Address - Country:US
Practice Address - Phone:803-325-7744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.126031207Q00000X, 207QA0401X
SCMD91234207QA0401X, 207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0182701Medicaid