Individual provider · Type 1 NPI

Roy Randel Henneberg, MD

Specialist · Coeur D Alene, ID

NPI number 1114956216 Active

Practice location

980 W Ironwood Dr, Suite 304
Coeur D Alene, ID 83814

Call (208) 765-4888 Map

Fax (208) 667-8618

Mailing address

980 W Ironwood Dr Ste 201
Coeur D Alene, ID 83814-2668

Other practice locations

  • 980 W Ironwood Dr Ste 201, Coeur D Alene, ID 83814-2668 · (208) 765-4888

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XM4722 (ID)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

22 other providers at this address

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About NPI 1114956216

Roy Randel Henneberg, MD's National Provider Identifier is 1114956216, issued on Jul 1, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Coeur D Alene, ID. The record was last updated on May 14, 2020.