Provider Demographics
NPI:1780665075
Name:HENDRICKSON, CHAD SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:SCOTT
Last Name:HENDRICKSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:100 INNOVATION DR
Mailing Address - Street 2:SUITE 103 BHS DERMATOLOGY ASSOCIATES CHAD HENDRICKSONMD
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-2468
Mailing Address - Country:US
Mailing Address - Phone:724-794-7923
Mailing Address - Fax:724-794-7931
Practice Address - Street 1:100 INNOVATION DR
Practice Address - Street 2:SUITE 103 BHS DERMATOLOGY ASSOCIATES CHAD HENDRICKSONMD
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-2468
Practice Address - Country:US
Practice Address - Phone:724-794-7923
Practice Address - Fax:724-794-7931
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2014-07-22
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Provider Licenses
StateLicense IDTaxonomies
PAMD447706207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology