Provider Demographics
NPI:1235208752
Name:HARMAN, JOHN SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SIMON
Last Name:HARMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 MEDICAL PARK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7632
Mailing Address - Country:US
Mailing Address - Phone:919-563-6132
Mailing Address - Fax:
Practice Address - Street 1:102 MEDICAL PARK DR
Practice Address - Street 2:SUITE C
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-7632
Practice Address - Country:US
Practice Address - Phone:919-563-6132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16141208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC230130OtherMEDICARE GROUP #
NC8939560Medicaid
NC207027BOtherPSC MEDICARE PROVIDER #
NC8939560Medicaid
NC230130OtherMEDICARE GROUP #