Individual
CLIFFORD DANIEL HENDRICKSON
Active
Individual
CLIFFORD DANIEL HENDRICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2016-02115
NC
207R00000X
Internal Medicine Physician
Primary
35.143460
OH
207R00000X
Internal Medicine Physician
4301071675
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1108124371
BCBS
MI
01
—
700H110750
BCBS
MI
01
—
C5702
MCARE
MI
Enumeration date
08/31/2006
Last updated
10/11/2022
Update your record
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