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

Phs Internal Medicine Dp317

Organization Internal Medicine Physician · NPI 1043474497

Phs Internal Medicine Dp317 is an Internal Medicine Physician in Washington, District of Columbia. Licensed in District of Columbia. Registered with an NPI since 2008.

Licensed in
DC
In the registry since
2008
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Practice location Address checks out

1160 Varnum St NE Depaul 317
Washington, DC 20017-2107
Phone: (202) 640-4837
Fax: (202) 636-1138
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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 number1043474497
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 enumeratedJuly 15, 2008
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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