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
Fax: (248) 858-3887
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972562106 NPPES
Michigan Other 0638406 BLUE CROSS/BLUE SHIELD
Michigan MEDICAID 4513265 BLUE CROSS/BLUE SHIELD

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