Dr. David R Hendricks
Internist - Addiction Medicine
153 1/2 E Front St
Traverse City
, Michigan 49684-5729
Dr. David R Hendricks
Internist - Addiction Medicine
153 1/2 E Front St
Traverse City
, Michigan 49684-5729
(231) 326-3026
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About
Features
Specialties
- Internist - Addiction Medicine
Languages spoken
- English
Location
First Address
- Dr. David R Hendricks
- 12100 S Benzonia Trl Suite D
- Empire, MI
- Zip : 49630-8503
- Fax : (231) 326-3026
- Phone : (231) 326-3002
Second Address
- Dr. David R Hendricks
- 153 1/2 E Front St
- Traverse City, MI
- Zip : 49684-5729
- Fax : (231) 941-6675
- Phone : (231) 941-6670
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RA0401X | Internist - Addiction Medicine | 4301038246 | MI |
National Provider Identifier
| NPI | 1013066406 |
|---|---|
| Provider Name | Dr. David R Hendricks |
| First Address | Empire, MI 49630-8503 |
| Second Address | Traverse City, MI 49684-5729 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/01/2007 |
| Last Update Date | 24/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 11-0-28-1081-1 | BLUE CROSS BLUE SHIELD (01) | MI |
| 4858998 | (05) | MI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.