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General NPI Number Information
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NPI Number | 1720068588
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Entity Type | Individual
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Provider Name | CAROL L HENWOOD D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 101 W 7TH ST STE 2A
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City | PENNSBURG
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State | PA
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Zip | 18073-1512
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Country | US
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Telephone | 484-763-5445
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Fax |
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Provider Business Mailing Address
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Address Line | 649 N LEWIS RD SUITE 130
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City | ROYERSFORD
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State | PA
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Zip | 19468-1234
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Country | US
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Telephone | 610-495-8101
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Fax | 610-495-8106
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS005316L
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License Number State | PA
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