Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 33413 | SC |
N | 207YP0228X | Pediatric Otolaryngology | 33413 | SC |
NPI | 1689885659 |
---|---|
Provider Name | George F Harris IV |
First Address | Goose Creek, SC 29445-5335 |
Second Address | Summerville, SC 29485-9039 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2007 |
Last Update Date | 10/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
334132 | (05) | SC |