Provider Demographics
NPI:1659119790
Name:HENDRIKS, THOMAS (MBBS, MPHIL, FRACS)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HENDRIKS
Suffix:
Gender:M
Credentials:MBBS, MPHIL, FRACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 BANK ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9228 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9125
Practice Address - Country:US
Practice Address - Phone:843-574-5693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-15
Last Update Date:2025-08-11
Deactivation Date:2025-05-20
Deactivation Code:
Reactivation Date:2025-08-11
Provider Licenses
StateLicense IDTaxonomies
SCLL95081207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology