Henderson, Vincent Charles

Henderson, Vincent Charles is an individual health care provider with primary practice located at 3575 Portage Rd , South Bend IN 46628-6092. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Henderson, Vincent Charles can be contacted via phone (574) 647-4530.

Contact Information

Primary practice address
3575 Portage Rd South Bend IN 46628-6092
Phone: (574) 647-4530
Fax: (574) 647-4531
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01033656A Indiana

Profile Details

NPI number 1275521452
LBN Legal business name Henderson, Vincent Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2005
Last updated Mar 17th, 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 1275521452 NPPES
Indiana Other 000000588530 BCBS BMG E BLAIR WARNER
Indiana Other 080073934 BCBS BMG E BLAIR WARNER
Indiana Other 000000085144 BCBS BMG E BLAIR WARNER
Indiana MEDICAID 200064640 BCBS BMG E BLAIR WARNER
Indiana Other 000000085145 BCBS BMG E BLAIR WARNER
Indiana Other 000000319907 BCBS BMG E BLAIR WARNER

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