1205006327 NPI number — MR. WAYNE CRAIG HARMAN MS, CRC, QRP

Table of content: MR. WAYNE CRAIG HARMAN MS, CRC, QRP (NPI 1205006327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205006327 NPI number — MR. WAYNE CRAIG HARMAN MS, CRC, QRP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARMAN
Provider First Name:
WAYNE
Provider Middle Name:
CRAIG
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS, CRC, QRP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205006327
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 COLLINS AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CLARKSBURG
Provider Business Mailing Address State Name:
WV
Provider Business Mailing Address Postal Code:
26301-3469
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
304-559-6978
Provider Business Mailing Address Fax Number:
304-622-2572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 COLLINS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CLARKSBURG
Provider Business Practice Location Address State Name:
WV
Provider Business Practice Location Address Postal Code:
26301-3469
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
304-559-6978
Provider Business Practice Location Address Fax Number:
304-622-2572
Provider Enumeration Date:
03/04/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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