Individual
DR. GAVIN L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201
(410) 328-6366
(410) 328-0693
Mailing address
PO BOX 64226, BALTIMORE, MD 21264-4226
(667) 214-1720
(410) 706-6976
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
D0053308
MD
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
D0053308
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407680000
—
MD
01
—
K51964580202
CAREFIRST
MD
01
—
W6620199
CAREFIRST
DC
Enumeration date
03/24/2006
Last updated
07/13/2018
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