Provider Demographics
NPI:1225228240
Name:HENRICHSEN, KAREN M (DO)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:HENRICHSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HIGHWAY 28 BYP
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29624-3742
Mailing Address - Country:US
Mailing Address - Phone:864-772-8173
Mailing Address - Fax:833-996-1161
Practice Address - Street 1:108 HIGHWAY 28 BYP
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29624-3742
Practice Address - Country:US
Practice Address - Phone:864-772-8173
Practice Address - Fax:833-996-1161
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC40745207R00000X
FLOS10165207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOS10165OtherFL LICENSE
SC40745OtherSOUTH CAROLINA MEDICAL BOARD