Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 0000-16878 | NC |
NPI | 1508956236 |
---|---|
Provider Name | Frederick Henderson |
First Address | Chapel Hill, NC 27516-2539 |
Second Address | Chapel Hill, NC 27599-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 20/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8941383 | (05) | NC |
C84442 | (02) | NC |