Henderson, Alberta Lee
Henderson, Alberta Lee is an individual health care provider with primary practice located at 714 N Michigan St , South Bend IN 46601-1035. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Henderson, Alberta Lee can be contacted via phone (574) 284-7477.Contact Information
Primary practice address
714 N Michigan St
South Bend IN 46601-1035
Phone: (574) 284-7477
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01043140A | Indiana |
Profile Details
| NPI number | 1477541654 |
|---|---|
| LBN Legal business name | Henderson, Alberta Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 11th, 2005 |
| Last updated | May 1st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1477541654 | NPPES |
| Indiana | MEDICAID | 200109040 |
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