Hendricks, Mark R
Hendricks, Mark R is an individual health care provider with primary practice located at 3100 Superior Ave , Sheboygan WI 53081-1948. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Hendricks, Mark R can be contacted via phone (920) 496-4700.Contact Information
Primary practice address
3100 Superior Ave
Sheboygan WI 53081-1948
Phone: (920) 496-4700
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 24824 | Wisconsin |
Profile Details
| NPI number | 1194768127 |
|---|---|
| LBN Legal business name | Hendricks, Mark R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2006 |
| Last updated | Jan 15th, 2010 - 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 | 1194768127 | NPPES |
| Wisconsin | MEDICAID | 31417300 |
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