Henderson, David B

Henderson, David B is an individual health care provider with primary practice located at 1638 Owen Dr , Fayetteville NC 28304-3424. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Henderson, David B can be contacted via phone (910) 609-4000.

Contact Information

Primary practice address
1638 Owen Dr Fayetteville NC 28304-3424
Phone: (910) 609-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 100436 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 100436 North Carolina

Profile Details

NPI number 1184615239
LBN Legal business name Henderson, David B
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 28th, 2005
Last updated Jul 12th, 2016 - about 10 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 1184615239 NPPES
Other 1184615239 TRICARE
MEDICAID 1184615239 TRICARE
Other 10436 TRICARE

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