Henry, Jerald W
Henry, Jerald W is an sole proprietor health care provider with primary practice located at 468 Cadieux Road , Grosse Pointe MI 48230. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Henry, Jerald W can be contacted via phone (313) 343-1630.Contact Information
Primary practice address
468 Cadieux Road
Grosse Pointe MI 48230
Phone: (313) 343-1630
Fax: (313) 343-1665
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 4301072837 | Michigan |
Profile Details
| NPI number | 1851359160 |
|---|---|
| LBN Legal business name | Henry, Jerald W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 3rd, 2006 |
| Last updated | Oct 31st, 2022 - about 2 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 | 1851359160 | NPPES |
| Michigan | Other | CB6220 | MEDICARE RR GROUP PIN |
| Michigan | Other | 310H249790 | MEDICARE RR GROUP PIN |
| Michigan | Other | P00063375 | MEDICARE RR GROUP PIN |
| Michigan | MEDICAID | 4536143 | MEDICARE RR GROUP PIN |
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