Individual
DEBRA L HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
800 WHEELING AVE, GLEN DALE, WV 26038-1660
(304) 845-3211
(304) 843-3202
Mailing address
800 WHEELING AVE, GLEN DALE, WV 26038-1660
(304) 845-3211
(304) 843-3202
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
15141
WV
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
15141
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052585000
—
WV
Enumeration date
09/21/2006
Last updated
08/20/2009
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