Healthcare Provider Details

I. General information

NPI: 1164504924
Provider Name (Legal Business Name): HARISH KHER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 03/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 N CLYDE MORRIS BLVD
DAYTONA BEACH FL
32114
US

IV. Provider business mailing address

601 N CLYDE MORRIS BLVD
DAYTONA BEACH FL
32114
US

V. Phone/Fax

Practice location:
  • Phone: 386-257-4777
  • Fax: 386-257-4776
Mailing address:
  • Phone: 386-257-4777
  • Fax: 386-257-4776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME42946
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: