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General NPI Number Information
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NPI Number | 1750342085
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Entity Type | Individual
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Provider Name | ANDREW P HARAKAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 601-A PROFESSIONAL DRIVE SUITE 130
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046
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Country | US
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Telephone | 678-551-7800
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Fax | 678-551-7802
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Provider Business Mailing Address
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Address Line | PO BOX 150
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City | WATKINSVILLE
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State | GA
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Zip | 30677-0004
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Country | US
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Telephone | 678-551-7800
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 32393
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License Number State | GA
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