Individual
ANITA LOUISE HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
11089 RESORT RD STE 206, ELLICOTT CITY, MD 21042-2073
(410) 696-3605
(410) 696-1387
Mailing address
11089 RESORT RD STE 206, ELLICOTT CITY, MD 21042-2073
(410) 696-3605
(410) 696-1387
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
D29175
MD
207NS0135X
Procedural Dermatology Physician
D29175
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
030771800
—
MD
Enumeration date
03/05/2007
Last updated
02/15/2023
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