Provider Demographics
NPI:1811012628
Name:HENRY, EARL W (MD)
Entity Type:Individual
Prefix:
First Name:EARL
Middle Name:W
Last Name:HENRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 HUNT CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:MD
Mailing Address - Zip Code:21152-9718
Mailing Address - Country:US
Mailing Address - Phone:410-785-3860
Mailing Address - Fax:
Practice Address - Street 1:HHI CLINICAL RSCH.
Practice Address - Street 2:224 SCHILLING CIRC,#160
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21031
Practice Address - Country:US
Practice Address - Phone:410-785-3860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA381832084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology