Provider Demographics
NPI:1992187447
Name:HENRY, STEPHEN (DPT)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:
Last Name:HENRY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 GREENSPRING DR FL 2
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3114
Mailing Address - Country:US
Mailing Address - Phone:410-989-3833
Mailing Address - Fax:
Practice Address - Street 1:18761 N FREDERICK AVE STE T
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3152
Practice Address - Country:US
Practice Address - Phone:410-989-3833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-22
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD25519225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD420640ZD6TMedicare PIN