Provider Demographics
NPI:1457302861
Name:FEIN, HENRY G (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:G
Last Name:FEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2401 W BELVEDERE AVE
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5216
Mailing Address - Country:US
Mailing Address - Phone:410-601-5524
Mailing Address - Fax:410-601-8946
Practice Address - Street 1:2435 W BELVEDERE AVE
Practice Address - Street 2:SUITE 56
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5224
Practice Address - Country:US
Practice Address - Phone:410-601-5961
Practice Address - Fax:410-601-9390
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0063594207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD408865400Medicaid
MDP00336469OtherR/R MEDICARE PROVIDER #
MDCB9283OtherR/R MEDICARE GROUP #
MDI43596Medicare UPIN
MD408865400Medicaid