Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 24199 | MN |
NPI | 1376522219 |
---|---|
Provider Name | Roger W Harms |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 12/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
160006889 | RAILROAD MEDICARE (01) | MN |
239220800 | (05) | MN |
35164800 | (05) | WI |
D81682 | (02) | |
ENROLLED | (05) | IA |