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

Providence Health Services

Organization Surgery Physician · NPI 1982868642

Providence Health Services is a Surgery 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 104
Washington, DC 20017-2107
Phone: (202) 854-4440
Fax: (202) 854-4430
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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)

Record details

NPI number1982868642
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Beau Higginbotham — Vice President/Coo · (410) 368-3162
Other names Phs General Surgery 104
NPI enumeratedJuly 11, 2008
Last updated in NPPESOctober 9, 2017
Mailing address1160 Varnum St Ne, St Catherine'S Hall Room 102, Washington, DC 20017-2107

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