Individual
BENJAMIN REID HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1210 W FARIS RD, GREENVILLE, SC 29605-4444
(864) 522-1800
(864) 522-1806
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
92545
SC
2085R0202X
Diagnostic Radiology Physician
MD.202606
LA
2085R0204X
Vascular & Interventional Radiology Physician
MD.202606
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50964
—
LA
Enumeration date
05/25/2007
Last updated
10/01/2024
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