Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 01051602A | IN |
Y | 2082S0105X | Plastic Hand Surgeon | 23236 | KY |
NPI | 1205820560 |
---|---|
Provider Name | Benedict Thomas Harter |
First Address | Louisville, KY 40202-1846 |
Second Address | Louisville, KY 40202-1846 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2005 |
Last Update Date | 12/06/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200233230A | (05) | IN |
64232366 | (05) | KY |
D32297 | (02) | KY |