Provider Demographics
NPI:1710333653
Name:HENZIE, DANIELLE (DO)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HENZIE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5777 W MAPLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2271
Mailing Address - Country:US
Mailing Address - Phone:248-932-9223
Mailing Address - Fax:248-932-8641
Practice Address - Street 1:5777 W MAPLE RD STE 200
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2271
Practice Address - Country:US
Practice Address - Phone:248-932-9223
Practice Address - Fax:248-932-8641
Is Sole Proprietor?:No
Enumeration Date:2016-05-10
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101025514207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology