# COEUR OBSTETRICS AND GYNECOLOGY, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** D. Anthony & R. Randel Henneberg, PTR's
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730280744
- **Authorized official:** DR. ANDREW ANTHONY HENNEBERG MD (OWNER/MD)
- **Authorized official phone:** (208) 765-4888

## Contact information

- **Practice address:** 980 W IRONWOOD DR STE 201, COEUR D ALENE, ID 83814-2668
- **Practice address phone:** (208) 765-4888
- **Mailing address:** 980 W IRONWOOD DR., SUITE 201, COEUR D' ALENE, ID 83814
- **Mailing address phone:** (208) 765-4888
- **Mailing address fax:** (208) 667-8618

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | M-9485 | ID | Yes |

## Other

- **Enumeration date:** 09/25/2006
- **Last updated:** 05/14/2020