Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Phs Internal Medicine Dp311

Organization Internal Medicine Physician · NPI 1124496013

Phs Internal Medicine Dp311 is an Internal Medicine Physician in Washington, District of Columbia. Licensed in District of Columbia. Registered with an NPI since 2015.

Licensed in
DC
In the registry since
2015
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Practice location Address checks out

1160 Varnum St NE Depaul 311
Washington, DC 20017-2107
Phone: (202) 854-4470
Fax: (202) 854-4471
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence HFD01-0212 (DC)

Record details

NPI number1124496013
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Beau Higginbotham — Vice President/Coo · (410) 368-3162
Other names Providence Health Services
NPI enumeratedSeptember 9, 2015
Last updated in NPPESOctober 10, 2017
Mailing address1160 Varnum St Ne, St Catherine'S Hall, Room 102, Washington, DC 20017-2107

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