Individual
DR. KENNETH H. MINCEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 SEA MOUNTAIN HWY, SUITE A, LITTLE RIVER, SC 29566-8161
(843) 399-9774
(843) 399-8657
Mailing address
3600 SEA MOUNTAIN HWY, SUITE A, LITTLE RIVER, SC 29566-8161
(843) 399-9774
(843) 399-8657
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
11033
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
570923578
BLUE CROSS BLUE SHIELD
SC
05
—
GP0444
—
SC
Enumeration date
12/15/2005
Last updated
05/18/2012
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