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Individual

RICHARD WESTBROOK HENNIG JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101012566
MI
207RC0000X
Cardiovascular Disease Physician
Primary
5101012566
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060B51089
BLUE CROSS
01
0B56351
HEALTH PLUS
05
113420288
MI
01
C4260
M-CARE
01
CN9425
MEDICARE RAILROAD
01
E74572
HAP
Enumeration date
12/14/2006
Last updated
08/29/2019
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