Provider Demographics
NPI:1235272121
Name:HARNEY, JOHN (MD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:HARNEY
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 1:4000 ANNAPOLIS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-3600
Mailing Address - Country:US
Mailing Address - Phone:410-636-9999
Mailing Address - Fax:410-636-6152
Practice Address - Street 1:4000 ANNAPOLIS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-3600
Practice Address - Country:US
Practice Address - Phone:410-636-9999
Practice Address - Fax:410-636-6152
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0021716207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
02238011OtherUNITED HEALTHCARE MA
M10796OtherCDS NUMBER
P1024AOtherCOVENTRY
07273OtherAMERIGROUP
505807OtherUS HEALTH
D0021716OtherLICENSE NUMBER
E2600001OtherBLUE CHOICE
5093453OtherAETNA
1378470ROtherFIRST HEALTH
813596OtherMAMSI OPT CHS MDIPA
000157156 0400181OtherUNITED HEALTHCARE
K697HAOtherBCBS
K697HAOtherBCBS
E2600001OtherBLUE CHOICE
M10796OtherCDS NUMBER