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PHS GEN SURG DP306 NPI 1457730244


NPI Information

NPI: 1457730244
Provider Name: PHS GEN SURG DP306

Doing Business As: PROVIDENCE HEALTH SERVICES

Classification: Surgery - 208600000X
Entity Type: Organization
Address:
1160 VARNUM ST NE
DEPAUL 306
WASHINGTON, DC
ZIP 20017
Phone: (202) 854-4069
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PHS GEN SURG DP306 is a surgery in Washington, DC. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. PHS GEN SURG DP306 NPI is 1457730244. 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 306
WASHINGTON, DC
ZIP 20017-107
Phone: (202) 854-4069
Fax: (202) 854-7825

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

The enumeration date for this NPI number is 5/26/2015 and was last updated on 10/9/2017.


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
1208600000XSurgeryHFD01-0212DISTRICT 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
1602021MEDICARE 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: 11/14/2023

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