Provider Type Icon

PHS GEN SURG DP307 NPI 1942546858


NPI Information

NPI: 1942546858
Provider Name: PHS GEN SURG DP307

Doing Business As: PROVIDENCE HEALTH SERVICES

Classification: Surgery - 208600000X
Entity Type: Organization
Address:
1160 VARNUM ST NE
DEPAUL 307
WASHINGTON, DC
ZIP 20017
Phone: (202) 854-4014
Get Directions

PHS GEN SURG DP307 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 DP307 NPI is 1942546858. The provider is registered as an organization entity type.
The provider Is Doing Business As Providence Health Services.

The provider's business location address is:

1160 VARNUM ST NE
DEPAUL 307
WASHINGTON, DC
ZIP 20017-107
Phone: (202) 854-4014
Fax: (202) 854-4082

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

The enumeration date for this NPI number is 12/20/2012 and was last updated on 10/5/2017.


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
1282N00000XGeneral Acute Care HospitalHFD01-0212DISTRICT OF COLUMBIANo
2208600000XSurgeryHFD01-0212DISTRICT 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
1005145400MEDICAIDMARYLAND
209810714MEDICAIDVIRGINIA
3029833400MEDICAIDDISTRICT OF COLUMBIA
4090006MEDICARE PIN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.