Henderson, Bruce T
Henderson, Bruce T is an individual health care provider with primary practice located at 44555 Woodward Ave Suite 407, Pontiac MI 48341-5031. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Henderson, Bruce T can be contacted via phone (248) 334-0524.Contact Information
Primary practice address
44555 Woodward Ave Suite 407
Pontiac MI 48341-5031
Phone: (248) 334-0524
Fax: (248) 858-3887
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 039951 | Michigan |
Profile Details
| NPI number | 1972562106 |
|---|---|
| LBN Legal business name | Henderson, Bruce T |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 17th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1972562106 | NPPES |
| Michigan | Other | 0638406 | BLUE CROSS/BLUE SHIELD |
| Michigan | MEDICAID | 4513265 | BLUE CROSS/BLUE SHIELD |
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