MEDICARE: DR. HAROLD ANTHONY COFER 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	207Q00000X	Family Medicine Physician	12594	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1270733	OTHER	UMWA CAREMARK
3	V002364	OTHER	TRICARE

General Provider Information

NPI Number	:	1891880506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAROLD ANTHONY COFER JR. MD

Provider Business Mailing Address
First Line	:	PO BOX 787
Second Line	:	MAIN ST
City	:	NORTHFOLK
State	:	WV
Zip	:	24868
Country	:	US
Telephone Number	:	304-862-3052
Fax Number	:	304-862-2107

Provider Business Practice Location Address
First Line	:	MAIN ST
Second Line	:
City	:	NORTHFOLK
State	:	WV
Zip	:	24868
Country	:	US
Telephone Number	:	304-862-3052
Fax Number	:	304-862-2107

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	07/08/2007

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