MEDICARE: ROBERT M. HARPOLD, MD, PLLC

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	21529	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225397508
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT M. HARPOLD, MD, PLLC

Provider Business Mailing Address
First Line	:	3418 STANTON AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304
Country	:	US
Telephone Number	:	304-720-3600
Fax Number	:	304-720-3602

Provider Business Practice Location Address
First Line	:	3418 STANTON AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304
Country	:	US
Telephone Number	:	304-720-3600
Fax Number	:	304-720-3602

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT MORRIS HARPOLD
Credential	:	MD
Telephone Number	:	304-720-3600

Provider Enumeration Date	:	05/08/2012
Last Update Date	:	05/08/2012

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