Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 0101221336 | VA |
NPI | 1174549935 |
---|---|
Provider Name | Norman R Harris II |
First Address | Roanoke, VA 24018-4357 |
Second Address | Roanoke, VA 24018-4357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6901573 | (05) | VA |
E07129 | (02) | VA |