Organization
PROVIDENCE HEALTH SERVICES
Active
Parent organization
PROVIDENCE HOSPITAL
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HOSPITAL
Authorized official
BEAU HIGGINBOTHAM (VICE PRESIDENT/COO)
(410) 368-3162
Entity
Organization
Contact information
Practice address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2149
(202) 269-7000
(202) 269-7825
Mailing address
1150 VARNUM ST NE, WASHINGTON, DC 20017-2149
(202) 269-7000
(202) 269-7825
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
HFD01-0212
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317201500
—
MD
Enumeration date
07/11/2008
Last updated
10/10/2017
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