Healthcare Provider Details

I. General information

NPI: 1225251192
Provider Name (Legal Business Name): DAVID STANLEY HARRER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 10/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3299 WOODBURN RD 210
ANNANDALE VA
22003-1275
US

IV. Provider business mailing address

10301 DEMOCRACY LN 410
FAIRFAX VA
22030-2545
US

V. Phone/Fax

Practice location:
  • Phone: 703-207-7072
  • Fax: 703-207-7074
Mailing address:
  • Phone: 703-876-5942
  • Fax: 703-208-1425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number0101020815
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: