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NPI Code Detail

MEDICARE: JEFFREY PEDEN HARRIS MD

MEDICARE: JEFFREY PEDEN HARRIS 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
1207RN0300XNephrology Physician0101025214VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740291772
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY PEDEN HARRIS MD
Provider Business Mailing Address
First Line : 1440 AMHERST STREET
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-3010
Country : US
Telephone Number : 540-450-3339
Fax Number : 540-450-3338
Provider Business Practice Location Address
First Line : 1440 AMHERST STREET
Second Line :
City : WINCHESTER
State : VA
Zip : 22601-3010
Country : US
Telephone Number : 540-450-3339
Fax Number : 540-450-3338
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 09/19/2012

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