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Organization

COEUR OBSTETRICS AND GYNECOLOGY, PLLC

Active
Other names
D. Anthony & R. Randel Henneberg, PTR's
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANDREW ANTHONY HENNEBERG MD (OWNER/MD)
(208) 765-4888
Entity
Organization

Contact information

Practice address
980 W IRONWOOD DR STE 201, COEUR D ALENE, ID 83814-2668
(208) 765-4888
Mailing address
980 W IRONWOOD DR., SUITE 201, COEUR D' ALENE, ID 83814
(208) 765-4888
(208) 667-8618

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-9485
ID

Other

Enumeration date
09/25/2006
Last updated
05/14/2020
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