Henderson, James Martin
Henderson, James Martin is an individual health care provider with primary practice located at 415 Morris St Suite 309, Charleston WV 25301-1842. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, Dental Providers / Oral and Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Henderson, James Martin can be contacted via phone (304) 388-3290.Contact Information
Primary practice address
415 Morris St Suite 309
Charleston WV 25301-1842
Phone: (304) 388-3290
Fax: (304) 388-3186
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 20470 | West Virginia |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 20470 | West Virginia |
Profile Details
| NPI number | 1295799963 |
|---|---|
| LBN Legal business name | Henderson, James Martin |
| Credentials | M.D./DDS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2006 |
| Last updated | Jun 9th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295799963 | NPPES |
| West Virginia | MEDICAID | 4002055001 | |
| West Virginia | Other | 850000287 | |
| West Virginia | MEDICAID | 4002055-000 |
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