MEDICARE: DR. MARTIN PAUL HARPEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	0101041784	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051944	OTHER	VA	ANTHEM BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134113384
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN PAUL HARPEN MD

Provider Business Mailing Address
First Line	:	3235 ACADEMY AVE
Second Line	:	STE 301
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-3200
Country	:	US
Telephone Number	:	757-484-9400
Fax Number	:	757-484-8809

Provider Business Practice Location Address
First Line	:	3235 ACADEMY AVE
Second Line	:	STE 301
City	:	PORTSMOUTH
State	:	VA
Zip	:	23703-3200
Country	:	US
Telephone Number	:	757-484-9400
Fax Number	:	757-484-8809

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	09/30/2013

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