Provider Demographics
NPI:1548265077
Name:HENSHAW, RAYMOND EDWARD II (MD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:EDWARD
Last Name:HENSHAW
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:600 18TH ST
Mailing Address - Street 2:STE 610
Mailing Address - City:PARKERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26101-3291
Mailing Address - Country:US
Mailing Address - Phone:304-424-4741
Mailing Address - Fax:304-424-4743
Practice Address - Street 1:600 18TH ST
Practice Address - Street 2:STE 610
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-3291
Practice Address - Country:US
Practice Address - Phone:304-424-4741
Practice Address - Fax:304-424-4743
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2008-09-08
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Provider Licenses
StateLicense IDTaxonomies
WV17162207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0097818000Medicaid
WV1104950001Medicare NSC
WV0097818000Medicaid