Provider Demographics
NPI:1659393817
Name:HARPER, AMY DENISE (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:DENISE
Last Name:HARPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:NEUROLOGY
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-0442
Practice Address - Fax:804-827-0941
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012603182084N0402X
NC2001010602084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
809208OtherPARTNERS
NC5906369Medicaid
SCQ0106DMedicaid
144KGOtherBCBS
NC2063601AMedicare PIN
195112OtherMEDCOST
VA1659393817Medicaid
WV3810008406Medicaid
809208OtherPARTNERS
NC2063601Medicare PIN