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General NPI Number Information
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NPI Number | 1386640118
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Entity Type | Individual
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Provider Name | HENRY PAUL JR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2005
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 2041 GEORGIA AVENUE NW DEPT OF SURGERY
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City | WASHINGTON
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State | DC
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Zip | 20060-3322
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Country | US
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Telephone | 202-865-3785
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Fax |
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Provider Business Mailing Address
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Address Line | 2041 GEORGIA AVE NW STE 6101
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City | WASHINGTON
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State | DC
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Zip | 20060-0001
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Country | US
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Telephone | 202-865-3785
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | L3777
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD036316
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License Number State | DC
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