Provider Demographics
NPI:1538128749
Name:KOHN, HARVEY D (MD)
Entity Type:Individual
Prefix:
First Name:HARVEY
Middle Name:D
Last Name:KOHN
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 1:505 LAUCHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAURINBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28352-5502
Mailing Address - Country:US
Mailing Address - Phone:910-277-1981
Mailing Address - Fax:910-277-1606
Practice Address - Street 1:505 LAUCHWOOD DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5502
Practice Address - Country:US
Practice Address - Phone:910-277-1981
Practice Address - Fax:910-277-1606
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300388174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC014W9OtherBLUE CROSS GROUP OF NC
NC50030OtherBLUE CROSS OF NC
SCNPB039Medicaid
NC89014W9Medicaid
562174805OtherTAX ID FOR COMMERCIAL
SCNPB039Medicaid
NC89014W9Medicaid