Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 28445 | SC |
N | 207XS0117X | Orthopaedic Spine Surgeon | J3682 | TX |
NPI | 1316938400 |
---|---|
Provider Name | Timothy Patrick Mchenry |
First Address | Greenville, SC 29615-4536 |
Second Address | Greenville, SC 29605-5622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2005 |
Last Update Date | 22/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H08876 | (02) | SC |