Individual
MICHAEL GERALD MCHENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3263 EATON ROAD, GREEN BAY, WI 54311
(920) 433-3456
Mailing address
3263 EATON ROAD, GREEN BAY, WI 54311
(920) 433-3456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
23152
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23152
LICENSE
WI
Enumeration date
12/06/2005
Last updated
05/11/2011
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