Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian Glenn Widenhouse, MD

Individual provider Plastic and Reconstructive Surgery Physician · NPI 1265481543

Brian Glenn Widenhouse, MD is a Plastic and Reconstructive Surgery in North Charleston, South Carolina. Graduated from Brody School of Medicine at East Carolina University in 1991, 35 years ago. Accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
35
Trained at
Brody School of Medicine at East Carolina University
Licensed in
SC
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2683 Lake Park Dr
North Charleston, SC 29406-9100
Phone: (843) 518-5000
Fax: (843) 614-8959
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence 20096 (SC)

Record details

NPI number1265481543
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 6, 2006
Last updated in NPPESApril 3, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPLASTIC AND RECONSTRUCTIVE SURGERY
Medical schoolBRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduated 1991 (35 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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