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General NPI Number Information
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NPI Number | 1457516379
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Entity Type | Individual
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Provider Name | HENRY SPENCER EDEN MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | BUILDING 13 ROOM 3N17 MSC #5766 NIH
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City | BETHESDA
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State | MD
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Zip | 20892
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Country | US
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Telephone | 301-435-1953
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Fax | 301-421-0010
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Provider Business Mailing Address
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Address Line | 3006 NOVAK TERRACE
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City | BURTONSVILLE
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State | MD
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Zip | 20866
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Country | US
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Telephone | 301-421-0023
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Fax | 301-421-0010
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | D12777
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License Number State | MD
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