MEDICARE: DR. CHARLES HARPER JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	24405	NE

General Provider Information

NPI Number	:	1063620961
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES HARPER JR. MD

Provider Business Mailing Address
First Line	:	1414 N 13TH ST
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-2669
Country	:	US
Telephone Number	:	402-316-4606
Fax Number	:	402-316-3469

Provider Business Practice Location Address
First Line	:	1414 N 13TH ST
Second Line	:
City	:	NORFOLK
State	:	NE
Zip	:	68701-2669
Country	:	US
Telephone Number	:	402-316-4606
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	08/22/2016

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