Individual
JEFFREY P HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 52ND ST SE, GRAND RAPIDS, MI 49512-9637
(616) 656-3700
(616) 656-3701
Mailing address
3700 52ND ST SE, GRAND RAPIDS, MI 49512-9637
(616) 656-3700
(616) 656-3701
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
JP075714
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JP075714
STATE LICENSE
MI
Enumeration date
07/26/2006
Last updated
07/08/2007
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