Provider Demographics
NPI:1497176176
Name:HARRER, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HARRER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 SAINT TIMOTHY CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-5329
Mailing Address - Country:US
Mailing Address - Phone:925-362-1549
Mailing Address - Fax:
Practice Address - Street 1:56 SAINT TIMOTHY CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-5329
Practice Address - Country:US
Practice Address - Phone:925-362-1549
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies