Individual
WILLIAM J HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3998 RED LION RD, SUITE 204, PHILADELPHIA, PA 19114-1445
(215) 612-5390
(215) 612-5658
Mailing address
PO BOX 8500-6335, PHILADELPHIA, PA 19178-6335
(215) 612-5390
(215) 612-5658
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD033208E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0011874410005
—
PA
01
—
0091405000
KEYSTONE IBC
PA
01
—
30124827
KEYSTONE FIRST
PA
01
—
4131823
AETNA PPO
PA
01
—
7508097
AETNA HMO
PA
01
—
HE 192740
BLUE SHIELD
PA
Enumeration date
10/24/2006
Last updated
07/01/2013
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