Hendricks, David R
Hendricks, David R is an individual health care provider with primary practice located at 153 1/2 E Front St , Traverse City MI 49684-5729. He recently has only one registered license in Allopathic & Osteopathic Physicians / Addiction Medicine, which is considered as his primary health care specialty. Hendricks, David R can be contacted via phone (231) 941-6670.Contact Information
Primary practice address
153 1/2 E Front St
Traverse City MI 49684-5729
Phone: (231) 941-6670
Fax: (231) 941-6675
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 4301038246 | Michigan |
Profile Details
| NPI number | 1013066406 |
|---|---|
| LBN Legal business name | Hendricks, David R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Aug 24th, 2021 - about 4 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 | 1013066406 | NPPES |
| Michigan | MEDICAID | 4858998 | |
| Michigan | Other | 11-0-28-1081-1 |
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