Provider Demographics
NPI:1679508857
Name:HENDRICK, DELIA CIMPEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DELIA
Middle Name:CIMPEAN
Last Name:HENDRICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DELIA
Other - Middle Name:
Other - Last Name:CIMPEAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DARTMOUTH-HITCHCOCK MEDICAL CENTER-LYME
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-650-1070
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DARTMOUTH-HITCHCOCK MEDICAL CENTER-LYME
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-650-1070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1845207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30203430Medicaid
VT1009532Medicaid
H71512Medicare UPIN
NH30203430Medicaid