Individual
JAMES MICHAEL HENEGHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
320 POMFRET ST, DEPARTMENT OF PATHOLOGY, PUTNAM, CT 06260-1836
(860) 928-6541
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
76901
MA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
76901
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001303388
—
CT
05
—
2091020
—
MA
Enumeration date
05/18/2006
Last updated
04/30/2009
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