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General NPI Number Information
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NPI Number | 1689730905
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Entity Type | Individual
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Provider Name | WALTER HARRIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 255 S 17TH ST SUITE 1002
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6231
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Country | US
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Telephone | 215-545-5001
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Fax | 215-545-5763
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Provider Business Mailing Address
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Address Line | 2000 HAMILTON ST RODIN PLACE SUITE 306
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City | PHILADELPHIA
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State | PA
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Zip | 19130-3814
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Country | US
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Telephone | 215-545-5001
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Fax | 215-545-5763
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD039446E
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License Number State | PA
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