Provider Demographics
NPI:1093705162
Name:HENDRIX, SYLVIA S (MD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:S
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 63201
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3201
Mailing Address - Country:US
Mailing Address - Phone:770-693-6022
Mailing Address - Fax:770-693-6039
Practice Address - Street 1:500 MARTHA JEFFERSON DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-4668
Practice Address - Country:US
Practice Address - Phone:434-654-8125
Practice Address - Fax:434-654-8127
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2015-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010480832085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI7203560Medicaid
VI920000034Medicare ID - Type UnspecifiedMEDICARE NUMBER
VI7203560Medicaid