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Individual

ROBERT CLARK HENDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
44 TIVERTON LN, ASHEVILLE, NC 28803-1909
(828) 505-2731
Mailing address
44 TIVERTON LN, ASHEVILLE, NC 28803-1909
(828) 505-2731

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
200201366
NC
207VG0400X
Gynecology Physician
Primary
200201366
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13222
BCBS
05
2007309000
WV
01
4504794
AETNA
05
6217354
VA
01
801640
PARTNERS
05
8913222
NC
01
C1683
MEDCOST
05
Q0136B
SC
Enumeration date
11/22/2005
Last updated
05/27/2010
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