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General NPI Number Information
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NPI Number | 1245959337
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Entity Type | Organization
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Legal Business Name | MELISSA HENDRIKS MD
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 322 S HARVEY ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-1693
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Country | US
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Telephone | 248-662-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 4202 ARLINGTON DR
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City | ROYAL OAK
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State | MI
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Zip | 48073-6304
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Country | US
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Telephone | 248-662-5511
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. MELISSA HENDRIKS
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Credential | MD
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Telephone | 248-662-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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