Healthcare Provider Details

I. General information

NPI: 1831213677
Provider Name (Legal Business Name): DAVID M HARMAN MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 06/29/2021
Certification Date: 06/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 OLD COURTHOUSE ROAD
APPOMATTOX VA
24522
US

IV. Provider business mailing address

PO BOX 45923
BALTIMORE MD
21297-5923
US

V. Phone/Fax

Practice location:
  • Phone: 434-352-0700
  • Fax: 434-352-2113
Mailing address:
  • Phone: 877-969-0392
  • Fax: 434-385-1414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101003238
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101003059
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101002961
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101002485
License Number StateVA
# 5
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101003235
License Number StateVA
# 6
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101001048
License Number StateVA
# 7
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number1101002612
License Number StateVA

VIII. Authorized Official

Name: AMY BURTON
Title or Position: RCM MANAGER
Credential:
Phone: 877-969-0392