Individual
DR. NATHAN HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR, SUITE 320, COLUMBIA, SC 29203
(803) 434-6771
(803) 434-3955
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1013
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010133
—
SC
01
—
P00924676
MEDICARE RAILROAD
SC
Enumeration date
07/25/2006
Last updated
08/27/2018
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