Henneberg, Andrew Anthony

Henneberg, Andrew Anthony is an individual health care provider with primary practice located at 980 W Ironwood Dr Suite 201, Coeur D Alene ID 83814. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is his primary health care specialty. Henneberg, Andrew Anthony can be contacted via phone (208) 765-4888.

Contact Information

Primary practice address
980 W Ironwood Dr Suite 201 Coeur D Alene ID 83814
Phone: (208) 765-4888
Fax: (208) 667-8618
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X M-9485 Idaho
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X M-9485 Idaho

Profile Details

NPI number 1689603847
LBN Legal business name Henneberg, Andrew Anthony
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2006
Last updated May 14th, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689603847 NPPES
Idaho MEDICAID 807438700

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