Provider Demographics
NPI:1619655677
Name:HARVEY, RICHARD M
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:HARVEY
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:PO BOX 20366
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44701-0366
Mailing Address - Country:US
Mailing Address - Phone:234-215-4637
Mailing Address - Fax:
Practice Address - Street 1:1320 10TH ST NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-3321
Practice Address - Country:US
Practice Address - Phone:330-265-4581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health