Provider Demographics
NPI:1316029762
Name:HENDRICKS, ANNE L (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:L
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2732 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-5751
Mailing Address - Country:US
Mailing Address - Phone:919-251-8609
Mailing Address - Fax:888-909-9793
Practice Address - Street 1:2121 GUESS RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-3338
Practice Address - Country:US
Practice Address - Phone:919-251-8609
Practice Address - Fax:888-909-9793
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2003011242084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89067MPMedicaid
NC14088OtherBCBS NUMBER