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NPI Code Detail

MEDICARE: DR. LUIS MARCELO HENKEL M.D.

MEDICARE: DR. LUIS MARCELO HENKEL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician233293MA

General Provider Information

NPI Number : 1578787248
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LUIS MARCELO HENKEL M.D.
Provider Business Mailing Address
First Line : 440 FOLEY ST
Second Line :
City : SOMERVILLE
State : MA
Zip : 02145-1213
Country : US
Telephone Number : 857-282-0777
Fax Number : 857-282-2386
Provider Business Practice Location Address
First Line : 440 FOLEY ST
Second Line :
City : SOMERVILLE
State : MA
Zip : 02145-1213
Country : US
Telephone Number : 857-282-0777
Fax Number : 857-282-2386
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2007
Last Update Date : 06/28/2025

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