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Individual

KENNETH BRYAN HELLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
113 WILDWOOD DR, BELTON, SC 29627-9687
(864) 940-9701
(864) 338-8760
Mailing address
PO BOX 846, BELTON, SC 29627-0846
(864) 940-9701
(864) 338-8760

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
09331
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
093311
SC
Enumeration date
07/12/2006
Last updated
08/23/2007
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