Provider Demographics
NPI:1326148305
Name:HENRY, MICHAEL A (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:A
Last Name:HENRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 PENNSYLVANIA PKWY STE 325
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46280-1398
Mailing Address - Country:US
Mailing Address - Phone:317-817-1800
Mailing Address - Fax:317-817-1810
Practice Address - Street 1:201 PENNSYLVANIA PKWY STE 325
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46280-1398
Practice Address - Country:US
Practice Address - Phone:317-817-1800
Practice Address - Fax:317-817-1810
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207VE0102X207VE0102X
IN01039467A207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology