Provider Demographics
NPI:1356448799
Name:HARNIST, KIMBERLY SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:SUE
Last Name:HARNIST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 BROOKTREE ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9288
Mailing Address - Country:US
Mailing Address - Phone:724-934-1600
Mailing Address - Fax:724-934-1620
Practice Address - Street 1:9000 BROOKTREE RD
Practice Address - Street 2:SUITE 400
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9255
Practice Address - Country:US
Practice Address - Phone:724-934-1600
Practice Address - Fax:724-934-1620
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD046770-L2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103854OtherUPMC
PA245035OtherHEALTHAMERICA
PA702671OtherHIGHMARK
PA103854OtherUPMC
PA245035OtherHEALTHAMERICA
PA702671OtherHIGHMARK