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NPI Code Detail

MEDICARE: DR. MICHAEL DAVID HENDERSON M.D.

MEDICARE: DR. MICHAEL DAVID HENDERSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RX0202XMedical Oncology Physician4301029337MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144219585
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL DAVID HENDERSON M.D.
Provider Business Mailing Address
First Line : 104 MILLIKEN CREEK DR
Second Line :
City : NAPA
State : CA
Zip : 94558-1241
Country : US
Telephone Number : 313-930-0909
Fax Number : 248-203-9110
Provider Business Practice Location Address
First Line : 2360 1ST ST
Second Line :
City : NAPA
State : CA
Zip : 94559-2239
Country : US
Telephone Number : 707-377-1007
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2005
Last Update Date : 06/23/2020

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