Healthcare Provider Details
I. General information
NPI: 1851389894
Provider Name (Legal Business Name): HENRY JOSEPH VENBRUX MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/13/2005
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
899 POPLAR CHURCH RD LOWR LEVEL
CAMP HILL PA
17011-2206
US
IV. Provider business mailing address
409 S 2ND ST STE 2F
HARRISBURG PA
17104-1612
US
V. Phone/Fax
- Phone: 717-763-0430
- Fax: 717-763-9854
- Phone: 717-843-8623
- Fax: 717-849-5382
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | MD024670E |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: