Herndon, Mark David

Herndon, Mark David is an individual health care provider with primary practice located at 1012 Medical Ridge Rd , Clinton SC 29325-4542. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Herndon, Mark David can be contacted via phone (864) 822-3852.

Contact Information

Primary practice address
1012 Medical Ridge Rd Clinton SC 29325-4542
Phone: (864) 822-3852
Fax: (864) 938-0501
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 58753 Georgia
Allopathic & Osteopathic Physicians / Surgery 208600000X 32321 South Carolina

Profile Details

NPI number 1285751107
LBN Legal business name Herndon, Mark David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2007
Last updated May 25th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285751107 NPPES
South Carolina MEDICAID 323215

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