DR. MARK HENDERSON (NPI# 1891895272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891895272 |
Entity Type | Individual |
Full Name | DR. MARK HENDERSON |
Credential | MD |
Practice Address |
900 Broadway Bangor ME 04401-1900 |
Mailing Address |
C/o St Marys Health System - Provider Enrollment Po Box 7291 Lewiston ME 04243-7291 |
Practice Telephone | 2079071187 |
Practice Fax Number | 2079071189 |
Mailing Telephone | 2077778560 |
Mailing Fax Number | 2077778800 |
Enumeration Date | 2006-09-25 |
Last Update Date | 2020-02-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
MD12208 | ME | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255372868 | Mark T Henderson | Emergency Medicine | 3607 Fern Valley Rd Ste 102, Louisville, KY 40219-1916 | 2006-06-08 |
1639139876 | Mark Shea Henderson | Surgery | 135 Plaza Dr, Suite 202, Sikeston, MO 63801-5136 | 2006-03-23 |
1992792840 | Mark William Henderson | Dentist | 23d Medical Group 3278 Mitchell Blvd, Moody Afb, GA 31699-1500 | 2005-10-05 |
1699245084 | Mark Henderson | Occupational Therapist | 28 Ritters Ridge Ct, Owings Mills, MD 21117-3355 | 2018-11-28 |
1760902498 | Mark E Henderson | Family Medicine | 4600 Valley Rd Ste 200, Lincoln, NE 68510-4882 | 2017-06-23 |
1407138167 | Mark Henderson | Pharmacist | 6958 Goodman Rd, Olive Branch, MS 38654-7034 | 2011-09-19 |
1184895856 | Mark C Henderson | Internal Medicine | 4860 Y St Ste 100, Sacramento, CA 95817-2307 | 2008-03-20 |
1912178229 | Mark Glen Henderson | Obstetrics & Gynecology | 2575 S Cimarron Rd, 102, Las Vegas, NV 89117-2682 | 2008-03-13 |
1841370707 | Mark A Henderson | Radiology | 2400 17th St, Columbus, IN 47201 | 2006-10-16 |
1376562082 | Mark Reagan Henderson | Dentist | 5700 Arnold St, Tinker Afb, OK 73145-8105 | 2006-07-19 |
Street Address |
900 BROADWAY |
City | BANGOR |
State | ME |
Zip Code | 04401-1900 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1083607253 | James J Nakashima | Internal Medicine | 900 Broadway, Bangor, ME 04401-1900 | 2005-08-23 |
1881210193 | Devon Courtney Malay | Nurse Practitioner | 900 Broadway, Bangor, ME 04401-1900 | 2020-06-23 |
1962937417 | Tina Marie Blackley | Nurse Practitioner | 900 Broadway, Bangor, ME 04401 | 2017-04-21 |
1134508518 | Ifeanyi Ioana Okam | Internal Medicine | 900 Broadway, Bangor, ME 04401 | 2015-05-19 |
1770911430 | Kristen L Druan | Nurse Practitioner | 900 Broadway, Bangor, ME 04401-1900 | 2013-10-16 |
1386980829 | Teresa M Bartlett | Nurse Practitioner | 900 Broadway, Bangor, ME 04401-1900 | 2013-01-02 |
1104160498 | Zachary Mitchell Greenier | Physician Assistant | 900 Broadway, Bangor, ME 04401-1900 | 2012-11-27 |
1437406444 | Deziree D Worster | Nurse Practitioner | 900 Broadway, Bangor, ME 04401 | 2012-08-08 |
1891059952 | Deborah H Higgins | Nurse Practitioner | 900 Broadway, Bangor, ME 04401-1900 | 2012-07-03 |
1316219322 | Ashley L Hadley | Nurse Practitioner | 900 Broadway, Bangor, ME 04401-1900 | 2012-02-07 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
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Taxonomy Code | 207RE0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Endocrinology, Diabetes & Metabolism |
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013327162 | Aaron Wade Barton | Internal Medicine | 885 Union St Ste 235, Bangor, ME 04401-3096 | 2014-04-29 |
1881092765 | St. Joseph Hospital | Internal Medicine | 360 Broadway, Bangor, ME 04401-3979 | 2014-12-09 |
1558637827 | Shazia Ahmad | Internal Medicine | 905 Union St Ste 11, Bangor, ME 04401-3039 | 2012-03-30 |
1750652822 | Poonam Khadka | Internal Medicine | 900 Broadway, Bangor, ME 04401-1900 | 2012-01-22 |
1184777062 | Ana X Mendoza Salazar | Internal Medicine | 900 Broadway, Bangor, ME 04401-1900 | 2007-01-22 |
1700804671 | Katarzyna Sadurska | Internal Medicine | 905 Union St, Suite 11, Bangor, ME 04401-3050 | 2006-07-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1518254903 | Roger Scott Rittmaster | Internal Medicine | 42 William Glen Dr, Camden, ME 04843-4431 | 2011-07-06 |
1881876266 | Celeste Cheryll Lopez Quianzon | Internal Medicine | 46 Fairview Ave Ste 335, Skowhegan, ME 04976-1481 | 2007-11-28 |
1962624189 | Thabo Kenosi | Internal Medicine | Mmp Endocrinology & Diabetes Center, 175 Us Route One, Scarborough, ME 04074-9308 | 2007-05-03 |
1437138955 | Wesley P Fairfield | Internal Medicine | 144 State St Fl 4, Portland, ME 04101-3776 | 2006-01-12 |
1811985963 | David Rawson Hotelling | Internal Medicine | 477 Congress St, 5th Floor, Portland, ME 04101-3427 | 2005-10-12 |
1942695093 | Rebecca Hillyer Leary | Internal Medicine | 175 Us Route 1, Scarborough, ME 04074-9048 | 2015-04-04 |
1699076133 | Mainehealth | Internal Medicine | 22 Bramhall St, Portland, ME 04102 | 2010-11-16 |
1134436165 | Metabolic Leader LLC | Internal Medicine | 51 Us Route 1 Ste H, Scarborough, ME 04074-7134 | 2010-09-13 |
1124344122 | Kiranjot Gujral | Internal Medicine | 175 Us Route One, Scarborough, ME 04074-9308 | 2010-04-15 |
1184857203 | Rashid Cheema | Internal Medicine | 140 Academy St, Presque Isle, ME 04769-3102 | 2009-08-24 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.