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Individual

MR. MICHAEL LAMAR HENDERSON JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MBA

Contact information

Practice address
2728 FISK RD, BALTIMORE, MD 21225-1328
(410) 279-1464
Mailing address
2728 FISK RD, BALTIMORE, MD 21225-1328
(410) 279-1464

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MD
174400000X
Specialist
MD

Other

Enumeration date
08/21/2024
Last updated
08/21/2024
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