Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 2009-01051 | NC |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 2009-01051 | NC |
NPI | 1134262694 |
---|---|
Provider Name | Scott Anderson Harper |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston Salem, NC 27157-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 25/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2076565 | MEDICARE (01) | |
5915933 | (05) | NC |