Phs Glenn Dale
Phs Glenn Dale is a Surgery Physician in Glenn Dale, Maryland. Licensed in District of Columbia. Registered with an NPI since 2011.
- Licensed in
- DC
- In the registry since
- 2011
- Specialties on file
- 2
Practice location Address checks out
12200 Annapolis Rd Ste 123Glenn Dale, MD 20769-9182
Phone: (202) 448-4014
Fax: (202) 372-0029
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgery Physician (primary) | Taxonomy 208600000X · Licence HFD01-0212 (DC) |
|---|---|
| General Acute Care Hospital | Taxonomy 282N00000X · Licence HFD01-0212 (DC) |
Record details
| NPI number | 1487922803 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | Providence Hospital |
| Authorized official | Beau Higginbotham — Vice President/Coo · (410) 368-3162 |
| Other names | Providence Health Services |
| NPI enumerated | December 13, 2011 |
| Last updated in NPPES | October 9, 2017 |
| Mailing address | 1160 Varnum St Ne, St Catherine'S Hall, Room 102, Washington, DC 20017-2107 |
Other providers in Glenn Dale
-
The Bariatric and Hernia Institute, PC
12150 Annapolis Rd Ste 309, Glenn Dale, MD 20769-9183 · (240) 206-8506