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General NPI Number Information
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NPI Number | 1316489131
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Entity Type | Individual
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Provider Name | BRETT HARMAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/10/2016
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 9100 MEDCOM ST
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9167
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Country | US
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Telephone | 843-569-3367
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Fax |
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Provider Business Mailing Address
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Address Line | 150 BEE ST APT 311
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City | CHARLESTON
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State | SC
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Zip | 29401-5701
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Country | US
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Telephone | 443-789-4326
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 2667
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License Number State | SC
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