Healthcare Provider Details

I. General information

NPI: 1851367239
Provider Name (Legal Business Name): TODD W HARVEY PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 FAIRGROVE CHURCH RD SUITE 1
HICKORY NC
28602-9617
US

IV. Provider business mailing address

350 STARNES CIRCLE DR
TAYLORSVILLE NC
28681-7622
US

V. Phone/Fax

Practice location:
  • Phone: 828-326-2550
  • Fax:
Mailing address:
  • Phone: 814-591-6472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number001000744
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: