Henneberry, Michael O
Henneberry, Michael O is an individual health care provider with primary practice located at 820 S Mcclellan St Suite 118, Spokane WA 99204-2457. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Henneberry, Michael O can be contacted via phone (509) 747-3147.Contact Information
Primary practice address
820 S Mcclellan St Suite 118
Spokane WA 99204-2457
Phone: (509) 747-3147
Fax: (509) 747-0020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD 00013902 | Washington |
Profile Details
| NPI number | 1336257971 |
|---|---|
| LBN Legal business name | Henneberry, Michael O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2006 |
| Last updated | Apr 19th, 2012 - about 12 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 | 1336257971 | NPPES |
| Washington | Other | 340011620 | RRB |
| Washington | Other | 22139 | RRB |
| Washington | MEDICAID | 8250003 | RRB |
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