David R Hendricks in Traverse City - Addiction Medicine
David R Hendricks - NPI 1013066406
David R Hendricks is a Addiction Medicine in Traverse City, Michigan. David R Hendricks practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for David R Hendricks is 1013066406. The last update date is 2021-08-24.
David R Hendricks's current location address is 153 1/2 E Front St, Traverse City, Michigan. You can contact this provider via phone number 2319416670 and fax number 2319416675. The mailing address for David R Hendricks is 153 1/2 E Front St, Traverse City, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | David R Hendricks |
|---|---|
| Address | 153 1/2 E Front St, Traverse City, Michigan |
| Phone Number | 2319416670 |
| Fax Number | 2319416675 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1013066406 |
|---|---|
| Provider Enumeration Date | 2007-01-09 |
| Last Updated Date | 2021-08-24 |
Provider Mailing Address Detail
| Address | 153 1/2 E Front St |
|---|---|
| City | Traverse City |
| State | Michigan (MI) |
| Post Code | 496845729 |
| Phone Number | 2319416670 |
| Fax Number | 2319416675 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 207Ra0401X |
| Licence No | 4301038246 |
|
Definition: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualification |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4858998 | MI | -- | |
| 11-0-28-1081-1 | MI | BLUE CROSS BLUE SHIELD |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to David R Hendricks by the Centers for Medicare & Medicaid Services?
The David R Hendricks has been issued the NPI (National Provider Identifier) 1013066406 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the David R Hendricks's physical address?
The David R Hendricks is physically located at 153 1/2 E Front St, in the city of Traverse City, MI, with the postal code 496845729.
What is David R Hendricks's specialized field of practice, and what is the corresponding taxonomy classification code?
The David R Hendricks's area of specialization is Addiction Medicine, and the corresponding taxonomy code that categorizes this field of practice is 207Ra0401X.
On what date did the David R Hendricks receive the assignment of its 1013066406 from the Centers for Medicare & Medicaid Services?
The David R Hendricks was issued its 1013066406 by the Centers for Medicare & Medicaid Services on 2007-01-09.
When was the David R Hendricks's information last updated?
The David R Hendricks's information was last updated on 2021-08-24.