MEDICARE: HENRY PAUL JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	L3777	TX
2	208200000X	Plastic Surgery Physician	MD036316	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386640118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY PAUL JR. MD

Provider Business Mailing Address
First Line	:	2041 GEORGIA AVE NW STE 6101
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20060-0001
Country	:	US
Telephone Number	:	202-865-3785
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 GEORGIA AVENUE NW DEPT OF SURGERY
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20060-3322
Country	:	US
Telephone Number	:	202-865-3785
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	10/22/2019

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