Provider Demographics
NPI:1376746453
Name:HENDERSON, BRITTANY BOHINC (MD)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:BOHINC
Last Name:HENDERSON
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 1:1054 JOHNNIE DODDS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3153
Mailing Address - Country:US
Mailing Address - Phone:843-388-7545
Mailing Address - Fax:843-388-5548
Practice Address - Street 1:1054 JOHNNIE DODDS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3153
Practice Address - Country:US
Practice Address - Phone:843-388-7545
Practice Address - Fax:843-388-5548
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD51944207RE0101X
NC2009-01742207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1376746453Medicaid
NC1376746453Medicaid