Individual
DR. BEN C PENDARVIS JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
940 HOLLY ST NE, ORANGEBURG, SC 29115-4930
(803) 536-2725
(803) 534-1441
Mailing address
940 HOLLY ST NE, ORANGEBURG, SC 29115-4930
(803) 536-2725
(803) 534-1441
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5230
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0966
—
SC
Enumeration date
07/19/2005
Last updated
07/08/2007
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