Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | D0061758 | MD |
NPI | 1104851336 |
---|---|
Provider Name | John Harvey |
First Address | Hollywood, MD 20636-4871 |
Second Address | Solomons, MD 20688 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 06/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I23732 | (02) | MD |
P00214504 | MEDICARE RAILRAOD (01) | MD |