Individual
DR. JEFFREY HARRIS HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
170 KIMEL PARK DR, WINSTON SALEM, NC 27103-6946
(704) 323-2000
Mailing address
4601 PARK RD, SUITE 250, CHARLOTTE, NC 28209-3239
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2011-00070
NC
207QS0010X
Sports Medicine (Family Medicine) Physician
2011-00070
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497704217
—
NC
Enumeration date
08/26/2008
Last updated
07/21/2022
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