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NPI Code Detail

MEDICARE: JUSTIN M HARBER

MEDICARE: JUSTIN M HARBER
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
1237700000XHearing Instrument Specialist17001385AIN

General Provider Information

NPI Number : 1558602904
Entity Type Code : Individual
Provider Name (Legal Business Name) : JUSTIN M HARBER
Provider Business Mailing Address
First Line : 10021 DUPONT CIRCLE CT
Second Line :
City : FORT WAYNE
State : IN
Zip : 46825-1604
Country : US
Telephone Number : 260-426-8117
Fax Number : 260-420-0817
Provider Business Practice Location Address
First Line : 1306 APPLE GLEN BLVD
Second Line :
City : FORT WAYNE
State : IN
Zip : 46804-1792
Country : US
Telephone Number : 260-459-6924
Fax Number : 260-420-0817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2013
Last Update Date : 03/11/2013

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