Healthcare Provider Details

I. General information

NPI: 1174630321
Provider Name (Legal Business Name): HAROLD EDWARD HARVEY II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 05/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 PROFESSIONAL PARK
BECKLEY WV
25801-3624
US

IV. Provider business mailing address

214 PROFESSIONAL PARK
BECKLEY WV
25801-3624
US

V. Phone/Fax

Practice location:
  • Phone: 304-252-5343
  • Fax: 304-252-6542
Mailing address:
  • Phone: 304-252-5343
  • Fax: 304-252-6542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number17024
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number17024
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: