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General NPI Number Information
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NPI Number | 1568533099
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Entity Type | Organization
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Legal Business Name | CAROLYN B. HENDRICKS, MD, PA
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 01/04/2011
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Provider Practice Location Address
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Address Line | 6410 ROCKLEDGE DR SUITE 506
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City | BETHESDA
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State | MD
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Zip | 20817-7822
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Country | US
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Telephone | 301-897-1503
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Fax | 301-581-0254
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Provider Business Mailing Address
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Address Line | 6410 ROCKLEDGE DR SUITE 506
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City | BETHESDA
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State | MD
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Zip | 20817-1809
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Country | US
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Telephone | 301-897-1503
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Fax | 301-581-0254
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | KELLY J ROSEMOND
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Credential |
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Telephone | 301-897-1503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D0037236
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License Number State | MD
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