Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 47761 | GA |
NPI | 1043213176 |
---|---|
Provider Name | Matthey T Harris |
First Address | Gainesville, GA 30501-3862 |
Second Address | Gainesville, GA 30501-3861 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 06/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I37335 | (02) |