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General NPI Number Information
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NPI Number | 1063438224
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Entity Type | Individual
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Provider Name | DOUGLAS ROSS HENSHAW MD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 01/17/2018
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Provider Practice Location Address
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Address Line | 2 RIVERVIEW DR
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City | DANBURY
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State | CT
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Zip | 06810-6268
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Country | US
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Telephone | 203-797-1500
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Fax | 203-730-9503
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Provider Business Mailing Address
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Address Line | 2 RIVERVIEW DR
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City | DANBURY
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State | CT
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Zip | 06810-6268
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Country | US
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Telephone | 203-797-1500
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Fax | 203-730-9503
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 043162
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 043162
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License Number State | CT
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