OrganizationActive
Providence Health Services, Inc
NPI 1366710766 · Otolaryngology Physician · Washington, DC
Provider details
- NPI number
- 1366710766
- Entity type
- Organization
- Primary specialty
- Otolaryngology PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Providence Hospital
- Organization subpart
- Yes
- Authorized official
- Beau Higginbothan, Vice President/Coo(410) 368-3182
- License
- HFD01-0212 (DC)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Hospitals
Practice location
1140 Varnum St Ne
Pmb 200
Washington, DC 20017-2151
Phone: (202) 854-4355
Fax: (202) 854-4398
Approximate (ZIP-level) locationGet directions
Mailing address
1160 Varnum St Ne
Washington, DC 20017-2107
Other names (DBA / former)
- Doing business as
- Phs Otolaryngology Pmb200
Registry dates
- Enumerated
- 2011-12-13
- Last updated
- 2018-02-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.