Healthcare Provider Details

I. General information

NPI: 1508138389
Provider Name (Legal Business Name): GEORGE ANTHONY HARRIS DC LICENSED/CST/CFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 05/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 NEW HAMPSHIRE AVE NW
WASHINGTON DC
20037
US

IV. Provider business mailing address

14911 FIRST BAPTIST LN
LAUREL MD
20707-6926
US

V. Phone/Fax

Practice location:
  • Phone: 202-659-0240
  • Fax: 202-955-5541
Mailing address:
  • Phone: 301-728-6874
  • Fax: 301-317-3310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License NumberSA0038
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: