Provider Demographics
NPI:1962644492
Name:HENDERSON, DAVID KELSO (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:KELSO
Last Name:HENDERSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ROOM 6 1480 BLDG 10
Mailing Address - Street 2:10 CENTER DRIVE
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-496-3515
Mailing Address - Fax:301-402-0244
Practice Address - Street 1:ROOM 6 1480 BLDG 10
Practice Address - Street 2:10 CENTER DRIVE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-3515
Practice Address - Fax:301-402-0244
Is Sole Proprietor?:No
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0024372207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease