Provider Demographics
NPI:1770844938
Name:HENDREN, WILLIAM GRANT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GRANT
Last Name:HENDREN
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:PO BOX 134
Mailing Address - Street 2:
Mailing Address - City:DUXBURY
Mailing Address - State:MA
Mailing Address - Zip Code:02331-0134
Mailing Address - Country:US
Mailing Address - Phone:781-934-9456
Mailing Address - Fax:
Practice Address - Street 1:232 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4548
Practice Address - Country:US
Practice Address - Phone:781-934-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85615208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)