Phs Glenn Dale
NPI 1487922803ActiveOrganization· Surgery· Glenn Dale, MD
Surgery in Glenn Dale, Maryland, registered in NPPES in December 2011, part of Providence Hospital. The authorized official on file is Beau Higginbotham, Vice President/Coo.
Overview
| NPI | 1487922803 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Providence Hospital |
| NPI issued | Dec 13, 2011 |
| Last updated in NPPES | Oct 9, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | HFD01-0212 | DC |
| General Acute Care Hospital | 282N00000X | HFD01-0212 | DC |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other general surgeons in Glenn Dale
- 1134536154