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General NPI Number Information
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NPI Number | 1457351488
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Entity Type | Individual
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Provider Name | MARK JOSEPH HENZES MD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2005
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 100 S JACKSON AVE AGH SUBURBAN CAMPUS
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City | PITTSBURGH
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State | PA
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Zip | 15202
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Country | US
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Telephone | 412-734-6100
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Fax | 412-734-6932
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Provider Business Mailing Address
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Address Line | 320 E NORTH AVE AGH EMERGENCY ASSOCS
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City | PITTSBURGH
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State | PA
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Zip | 15212
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Country | US
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Telephone | 412-359-4138
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Fax | 412-359-8874
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD039291
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License Number State | PA
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