Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | D46085 | MD |
NPI | 1043219124 |
---|---|
Provider Name | Dr. Mark Hendrix |
First Address | Rockville, MD 20852-4250 |
Second Address | Rockville, MD 20852-4250 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 02/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
592361100 | (05) | MD |
F83414 | (02) |