Individual
CHARLES GERRY HENDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9300 DEWITT LOOP, ATTN: UROLOGY, FORT BELVOIR COMMUNITY HOSPITAL, FORT BELVOIR, VA 22060
(571) 231-2633
(571) 231-2611
Mailing address
2724 FORT SCOTT DR, ARLINGTON, VA 22202-2305
(240) 505-5402
(571) 231-2611
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
18271
AL
2088P0231X
Pediatric Urology Physician
18271
AL
2088P0231X
Pediatric Urology Physician
G188367
CA
2088P0231X
Pediatric Urology Physician
Primary
ME131967
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021315000
—
FL
Enumeration date
12/09/2006
Last updated
05/06/2024
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