Provider Demographics
NPI:1730279886
Name:HARVEY, CAROLINE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:
Last Name:HARVEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MURDOCK RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1745
Mailing Address - Country:US
Mailing Address - Phone:410-377-9598
Mailing Address - Fax:
Practice Address - Street 1:10 FILA WAY
Practice Address - Street 2:STE. 205
Practice Address - City:SPARKS
Practice Address - State:MD
Practice Address - Zip Code:21152-9452
Practice Address - Country:US
Practice Address - Phone:410-472-1006
Practice Address - Fax:410-472-0900
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0003272363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant