Doctor Name: | ERROL DUDLEY HENRIQUES |
NPI Number: | 1255440947 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD 21972L |
Business Practice Address: | 519 North Caroline Street Ebensburg, PA - 15931 |
Business Phone Number: | 8144726401 |
Business Fax Number: | 8144727449 |
Mailing Address: | 519 North Caroline Street, EBENSBURG |
State: | PA |
Postal Code: | 15931 |
Phone Number: | 8144726401 |
Fax Number: | 8144727449 |
NPI Enumeration Date: | 08/29/2006 |
NPI Last Update Date: | 08/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD 21972L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |