IndividualActive
Brett Henderson, D.O.
NPI 1639521289 · Gastroenterology Physician · Maple Grove, MN
Provider details
- NPI number
- 1639521289
- Entity type
- Individual
- Primary specialty
- Gastroenterology PhysicianAllopathic & Osteopathic Physicians
- Credential
- D.O.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 70679 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
10150 Niagara Ln N
Maple Grove, MN 55369-7588
Phone: (612) 870-5491
Fax: (612) 870-5491
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 14909
Minneapolis, MN 55414-0909
Registry dates
- Enumerated
- 2016-07-07
- Last updated
- 2022-07-26
- Certified
- 2022-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.