Provider Demographics
NPI:1891189171
Name:HENNING, WERNER HEINRICH (DO)
Entity Type:Individual
Prefix:DR
First Name:WERNER
Middle Name:HEINRICH
Last Name:HENNING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 S WASHINGTON AVE
Mailing Address - Street 2:STE 300
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-2202
Mailing Address - Country:US
Mailing Address - Phone:517-487-8255
Mailing Address - Fax:517-487-2059
Practice Address - Street 1:1230 COLINBROOK CIR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-3608
Practice Address - Country:US
Practice Address - Phone:317-370-0157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022115208600000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program