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Individual

GERALD J HENKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1543 S 7TH ST, TERRE HAUTE, IN 47802-1610
(812) 235-9980
(812) 234-7314
Mailing address
1543 S 7TH ST, TERRE HAUTE, IN 47802-1610
(812) 235-9980
(812) 234-7314

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
07000314A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000090292
BLUE CROSS BLUE SHIELD #
IN
05
00249940A
IN
01
351924167
TAX ID #
IN
Enumeration date
04/14/2007
Last updated
01/14/2010
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