Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 041576 | GA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 041576 | GA |
NPI | 1316934763 |
---|---|
Provider Name | Dr. Peter S. Harvey |
First Address | Morrow, GA 30260-2354 |
Second Address | Morrow, GA 30260-2354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 27/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E24252 | (02) | GA |