MEDICARE: DR. BRITTANY BOHINC HENDERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	MD51944	SC
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	2009-01742	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376746453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRITTANY BOHINC HENDERSON MD

Provider Business Mailing Address
First Line	:	1054 JOHNNIE DODDS BLVD STE A
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3153
Country	:	US
Telephone Number	:	843-388-7545
Fax Number	:	843-388-5548

Provider Business Practice Location Address
First Line	:	1054 JOHNNIE DODDS BLVD STE A
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3153
Country	:	US
Telephone Number	:	843-388-7545
Fax Number	:	843-388-5548

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2007
Last Update Date	:	01/23/2019

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