Provider Demographics
NPI:1437339959
Name:SAUNDERS, HENRY V (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:V
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1831 W EVANS ST
Mailing Address - Street 2:STE 315
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-3300
Mailing Address - Country:US
Mailing Address - Phone:281-917-3977
Mailing Address - Fax:832-553-7783
Practice Address - Street 1:8002 MYRTLE TRACE DR
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:SC
Practice Address - Zip Code:29526-8945
Practice Address - Country:US
Practice Address - Phone:843-347-7227
Practice Address - Fax:843-347-7232
Is Sole Proprietor?:No
Enumeration Date:2007-11-13
Last Update Date:2017-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC120327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP4505Medicaid
SC120327Medicaid
SCPA8688Medicaid
SC7844Medicare PIN
SC2569Medicare PIN
SCC60272Medicare UPIN