Individual
DR. MICHAEL POTTER HENDERSON
Active
Individual
DR. MICHAEL POTTER HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101242252
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427135086
OPTIMA BEHAVIORAL HEALTH
VA
05
—
1427135086
—
VA
01
—
413231
ANTHEM BC/BS
VA
05
—
5916090
—
NC
01
—
600484-052
MAGELLAN HEALTH SERVICES
VA
01
—
PAR
MANAGED HEALTH NETWORK/TRICARE
VA
Enumeration date
11/01/2006
Last updated
05/07/2014
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