Healthcare Provider Details

I. General information

NPI: 1871662551
Provider Name (Legal Business Name): HENRY C BARBOT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 N SAINT ASAPH ST
ALEXANDRIA VA
22314-1912
US

IV. Provider business mailing address

13700 HOTOMTOT DR
UPPER MARLBORO MD
20774-7156
US

V. Phone/Fax

Practice location:
  • Phone: 703-838-4455
  • Fax: 703-838-5070
Mailing address:
  • Phone: 703-838-6400
  • Fax: 703-838-5070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0101050697
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: