Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 01037057A | IN |
Y | 207QS0010X | Family Doctor - Sports Medicine | 01037057A | IN |
NPI | 1326022773 |
---|---|
Provider Name | David M Harsha |
First Address | Danville, IN 46122-2000 |
Second Address | Danville, IN 46122-2000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2005 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100262460 | (05) | IN |
E05979 | (02) |