Individual
DR. JERRY PAUL HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-7604
Mailing address
5900 BYRON CENTER AVE SW, WYOMING, MI 49519-9606
(616) 252-7604
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021016736
MO
207P00000X
Emergency Medicine Physician
510123790
MI
Other
Enumeration date
06/26/2018
Last updated
07/28/2021
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