Individual
TIMOTHY HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
149 NORTH ST, MGHA HOSPITALIST PROGRAM, WATERVILLE, ME 04901-4974
(207) 626-1018
(207) 872-1214
Mailing address
149 NORTH ST, MGHA HOSPITALIST PROGRAM, WATERVILLE, ME 04901-4974
(207) 626-1018
(207) 626-1214
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01573
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
310310099
—
ME
Enumeration date
02/23/2006
Last updated
07/03/2008
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