Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | D0064056 | MD |
NPI | 1134135098 |
---|---|
Provider Name | Dr. Mark Jan Harrison |
First Address | North Potomac, MD 20878-3847 |
Second Address | North Potomac, MD 20878-3847 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 05/11/2009 |