Individual
DR. DAVID R HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
153 1/2 E FRONT ST, TRAVERSE CITY, MI 49684-5729
(231) 941-6670
(231) 941-6675
Mailing address
12100 S BENZONIA TRL, SUITE D, EMPIRE, MI 49630-8503
(231) 326-3002
(231) 326-3026
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
4301038246
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-0-28-1081-1
BLUE CROSS BLUE SHIELD
MI
05
—
4858998
—
MI
Enumeration date
01/09/2007
Last updated
08/24/2021
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