=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558478958
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID M HARMAN MD LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2006
-----------------------------------------------------
Last Update Date | 06/21/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 204 AMBRIAR PLAZA
-----------------------------------------------------
City | AMHERST
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 434-946-2020
-----------------------------------------------------
Fax | 434-455-7172
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 45923
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21297-5923
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-969-0392
-----------------------------------------------------
Fax | 434-455-7172
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RCM MANAGER
-----------------------------------------------------
Name | AMY BURTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 434-385-5600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------