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General NPI Number Information
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NPI Number | 1740350883
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Entity Type | Individual
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Provider Name | MAX A HARNED MD FAAP PHD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | ONE MEMORIAL DRIVE RT 26 NORTH
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City | BRUCETON MILLS
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State | WV
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Zip | 26525-9500
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Country | US
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Telephone | 304-379-2114
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Fax | 304-379-7929
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Provider Business Mailing Address
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Address Line | ONE MEMORIAL DRIVE HARNED MEMORIAL MEDICAL CLINIC INC
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City | BRUCETON MILLS
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State | WV
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Zip | 26525-9500
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Country | US
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Telephone | 304-379-2114
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Fax | 304-379-7929
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 12679
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License Number State | WV
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