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

Phs Gen Surg Dp307

Organization Surgery Physician · NPI 1942546858

Phs Gen Surg Dp307 provides Surgery Physician services in Washington, District of Columbia. Licensed in District of Columbia. Registered with an NPI since 2012.

Licensed in
DC
In the registry since
2012
Specialties on file
2

Practice location Address checks out

1160 Varnum St NE Depaul 307
Washington, DC 20017-2107
Phone: (202) 854-4014
Fax: (202) 854-4082
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence HFD01-0212 (DC)
General Acute Care Hospital Taxonomy 282N00000X · Licence HFD01-0212 (DC)

Record details

NPI number1942546858
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Hospital
Authorized official Beau Higginbotham — Cive President/Coo · (410) 368-3162
Other names Providence Health Services
NPI enumeratedDecember 20, 2012
Last updated in NPPESOctober 5, 2017
Mailing address1160 Varnum St Ne, St Catherine'S Hall, Room 102, Washington, DC 20017-2107

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