Provider Demographics
NPI:1164684809
Name:HENNINGER, ERIK PETER (DO)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:PETER
Last Name:HENNINGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4810 WHITESPORT CIR SW STE 100
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-7420
Mailing Address - Country:US
Mailing Address - Phone:256-429-4500
Mailing Address - Fax:256-429-4503
Practice Address - Street 1:4810 WHITESPORT CIR SW STE 100
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-7420
Practice Address - Country:US
Practice Address - Phone:256-429-4500
Practice Address - Fax:256-429-4503
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALDO.1206208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I377016Medicare UPIN