Provider Demographics
NPI:1073716809
Name:HENZEL, MARY KRISTINA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:KRISTINA
Last Name:HENZEL
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Gender:F
Credentials:MD, PHD
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Mailing Address - Street 1:10701 EAST BLVD
Mailing Address - Street 2:LOUIS STOKES CLEVELAND VA MEDICAL CENTER, 128(W)
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-1702
Mailing Address - Country:US
Mailing Address - Phone:216-791-3800
Mailing Address - Fax:216-707-5912
Practice Address - Street 1:10701 EAST BLVD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1702
Practice Address - Country:US
Practice Address - Phone:216-791-3800
Practice Address - Fax:216-707-5912
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2023-09-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4391782081P0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine