MEDICARE: MR. MAX A HARNED MD FAAP PHD

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	207Q00000X	Family Medicine Physician	12679	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	1066800	OTHER	WORKERS COMPENSATION
2	111038	OTHER	CARE LINK
3	171900	OTHER	BLACK LUNG
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740350883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MAX A HARNED MD FAAP PHD

Provider Business Mailing Address
First Line	:	ONE MEMORIAL DRIVE
Second Line	:	HARNED MEMORIAL MEDICAL CLINIC INC
City	:	BRUCETON MILLS
State	:	WV
Zip	:	26525-9500
Country	:	US
Telephone Number	:	304-379-2114
Fax Number	:	304-379-7929

Provider Business Practice Location Address
First Line	:	ONE MEMORIAL DRIVE
Second Line	:	RT 26 NORTH
City	:	BRUCETON MILLS
State	:	WV
Zip	:	26525-9500
Country	:	US
Telephone Number	:	304-379-2114
Fax Number	:	304-379-7929

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	07/08/2007

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