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PHS INTERNAL MEDICINE DP311 NPI 1124496013


NPI Information

NPI: 1124496013
Provider Name: PHS INTERNAL MEDICINE DP311

Doing Business As: PROVIDENCE HEALTH SERVICES

Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
1160 VARNUM ST NE
DEPAUL 311
WASHINGTON, DC
ZIP 20017
Phone: (202) 854-4470
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PHS INTERNAL MEDICINE DP311 is an internal medicine in Washington, DC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PHS INTERNAL MEDICINE DP311 NPI is 1124496013. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Providence Health Services.

The provider's business location address is:

1160 VARNUM ST NE
DEPAUL 311
WASHINGTON, DC
ZIP 20017-107
Phone: (202) 854-4470
Fax: (202) 854-4471

The provider's authorized official is Beau Higginbotham .
The authorized official title is Vice President/coo and has the following contact phone number (410) 368-3162.

The enumeration date for this NPI number is 9/9/2015 and was last updated on 10/10/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineHFD01-0212DISTRICT OF COLUMBIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1726277MEDICARE PINDISTRICT OF COLUMBIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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