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General NPI Number Information
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NPI Number | 1205401098
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Entity Type | Individual
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Provider Name | HENRI PAUL WATHIEU MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2021
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 164 SUMMIT AVE
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City | PROVIDENCE
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State | RI
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Zip | 02906-2853
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Country | US
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Telephone | 401-793-4501
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Fax | 401-793-4511
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-0000
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Fax | 410-500-4266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD19857
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License Number State | RI
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