Provider Demographics
NPI:1609853530
Name:HARMAN, THOMAS R (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
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 1:3070 WELLNER DR NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906-8427
Mailing Address - Country:US
Mailing Address - Phone:507-218-3095
Mailing Address - Fax:507-218-3097
Practice Address - Street 1:3070 WELLNER DR NE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55906-8427
Practice Address - Country:US
Practice Address - Phone:507-218-3095
Practice Address - Fax:507-218-3097
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-30
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN21950207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN074387900Medicaid
MN080001207Medicare ID - Type Unspecified
D81146Medicare UPIN
MN080013589Medicare ID - Type UnspecifiedRAILROAD