Individual
KENNETH I HENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8650 SUDLEY ROAD, # 206, MANASSAS, VA 20110
(703) 368-9234
(703) 368-0505
Mailing address
8650 SUDLEY ROAD, # 206, MANASSAS, VA 20110
(703) 368-9234
(703) 368-0505
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101049560
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
210992
ANTHEM BCBS
VI
Enumeration date
07/07/2006
Last updated
07/08/2007
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