Individual
JANICE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4940 EASTERN AVE, BALTIMORE, MD 21224-2735
(410) 550-7802
Mailing address
PO BOX 64313, BALTIMORE, MD 21264-4313
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
D59091
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
458802900
—
MD
Enumeration date
05/11/2006
Last updated
12/05/2012
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