MEDICARE: NATHAN MIKAEL HARMON

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	207P00000X	Emergency Medicine Physician	R-8376	IA

Other Identifiers

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

General Provider Information

NPI Number	:	1790944999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHAN MIKAEL HARMON

Provider Business Mailing Address
First Line	:	3421 W 9TH ST
Second Line	:
City	:	WATERLOO
State	:	IA
Zip	:	50702-5401
Country	:	US
Telephone Number	:	319-330-9145
Fax Number	:

Provider Business Practice Location Address
First Line	:	1215 AMELIA DR
Second Line	:	APT 2
City	:	CEDAR FALLS
State	:	IA
Zip	:	50613-7982
Country	:	US
Telephone Number	:	319-330-9145
Fax Number	:

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

Provider Enumeration Date	:	06/03/2008
Last Update Date	:	07/06/2011

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