Provider Demographics
NPI:1578574257
Name:GIVRE, HENRY L (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:L
Last Name:GIVRE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1780 EAST FLORENCE BOULEVARD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122
Mailing Address - Country:US
Mailing Address - Phone:520-836-8701
Mailing Address - Fax:520-836-1993
Practice Address - Street 1:1780 EAST FLORENCE BOULEVARD
Practice Address - Street 2:SUITE 110
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:520-836-8701
Practice Address - Fax:520-836-1993
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2016-09-16
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Provider Licenses
StateLicense IDTaxonomies
AZ13200207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ232223Medicaid