Doctor Name: | DR. WALTER DAVID HARRIS |
NPI Number: | 1205126992 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | ME47899 |
Business Practice Address: | 4485 Furling Ln Destin, FL - 325415331 |
Business Phone Number: | 8506548015 |
Business Fax Number: | 8506543380 |
Mailing Address: | 4485 Furling Ln, DESTIN |
State: | FL |
Postal Code: | 325415331 |
Phone Number: | 8506548015 |
Fax Number: | 8506543380 |
NPI Enumeration Date: | 04/14/2011 |
NPI Last Update Date: | 04/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | ME47899 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |