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Contact Information

HENDERSON CLINIC FOR WOMEN PA
511 RUIN CREEK RD
STE 101
HENDERSON, NC27536-5919
 Phone: 252-492-8576
 Fax: 252-492-7464
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Legal Medicine

173000000X
Indicates primary specialty

NPI Profile & details for HENDERSON CLINIC FOR WOMEN PA · (Female)

NPI # 1104829183
Status Active
Credentials
Entity Individual
Enumeration date 05/24/2005
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # 39877
  • NC Medicaid 89-01757
  • NC Other 7808539 AETNA GROUP ID
  • NC Other 16402 WELLPATH GROUP ID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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