Individual
MARK DAVID HENIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
23 SUNNYBROOK RD, RALEIGH, NC 27610-1855
(919) 350-7584
(919) 231-0314
Mailing address
PO BOX 603949, CHARLOTTE, NC 28260-3949
(919) 350-0351
(919) 350-7687
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
173590
NC
208000000X
Pediatrics Physician
2014-00498
NC
2080P0205X
Pediatric Endocrinology Physician
Primary
2014-00498
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962793422
—
NC
05
—
368364
—
SC
Enumeration date
05/02/2011
Last updated
12/08/2022
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