Provider Demographics
NPI:1982865705
Name:HENRY, DUNCAN M (MD)
Entity Type:Individual
Prefix:DR
First Name:DUNCAN
Middle Name:M
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 1:1 BOSTON MEDICAL CTR PL
Mailing Address - Street 2:DEPARTMENT OF PEDIATRICS, DOWLING 3 SOUTH
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-2908
Mailing Address - Country:US
Mailing Address - Phone:617-414-5170
Mailing Address - Fax:617-414-3803
Practice Address - Street 1:840 HARRISON AVE
Practice Address - Street 2:MENINO 4
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-2905
Practice Address - Country:US
Practice Address - Phone:617-414-4511
Practice Address - Fax:617-414-3171
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA247020208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics