Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 0101017780 | VA |
NPI | 1003880345 |
---|---|
Provider Name | Howard Courtenay Harrison SR. |
First Address | Portsmouth, VA 23707-0068 |
Second Address | Virginia Beach, VA 23454-2409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
37156 | SENTARA/OPTIMA (01) | VA |
461501 | ANTHEM (01) | VA |
E06925 | (02) | VA |