David F Henderson, MD

Individual provider Active NPI Internal Medicine Physician · Bristol, VT

NPI 1043344633 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043344633
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
0420005493 (VT)
Practice address
6 South St
Bristol, VT 05443-1217
Phone
(802) 453-2451
Fax
(802) 453-5816
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420005493VTMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0420005493 VT Yes

Addresses

Primary practice location

6 South St
Bristol, VT 05443-1217

Mailing address

6 South St
Bristol, VT 05443-1217
Phone (802) 453-2451

Other identifiers

IdentifierTypeStateIssuer
0004598MedicaidVT

Other providers in Bristol, VT

All providers in Bristol, VT · Internal Medicine Physician in Vermont

Sources for this page

Verify at the official NPI Registry.