Individual
DR. MARK DAVID HERNDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1012 MEDICAL RIDGE RD, CLINTON, SC 29325-4542
(864) 822-3852
(864) 938-0501
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
32321
SC
208600000X
Surgery Physician
58753
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
323215
—
SC
Enumeration date
03/24/2007
Last updated
05/25/2021
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