Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | MD421946 | PA |
NPI | 1083666507 |
---|---|
Provider Name | Kimberly S Harbaugh |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 17/07/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0019577220001 | (05) | PA |
G38181 | (02) |