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General NPI Number Information
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NPI Number | 1154462117
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Entity Type | Organization
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Legal Business Name | EMDEE CLINICA, PLLC
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 23164 KESTREL DR
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City | BRISTOL
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State | VA
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Zip | 24202
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Country | US
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Telephone | 423-341-3040
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Fax |
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Provider Business Mailing Address
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Address Line | 23164 KESTREL DR
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City | BRISTOL
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State | VA
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Zip | 24202-5070
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Country | US
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Telephone | 423-341-3040
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Fax |
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Authorized Official
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Title or Position | FOUNDER/PHYSICIAN
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Name | DR. DEBRA LYNN HARMAN
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Credential | MD, FAAFP
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Telephone | 423-341-3040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 37264
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 0101052898
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License Number State | VA
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