Provider Demographics
NPI:1801826144
Name:HARLAN, STEVEN LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:LEE
Last Name:HARLAN
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 1:8131 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1123
Mailing Address - Country:US
Mailing Address - Phone:515-225-8180
Mailing Address - Fax:515-225-2041
Practice Address - Street 1:8131 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1123
Practice Address - Country:US
Practice Address - Phone:515-225-8180
Practice Address - Fax:515-225-2041
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2014-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22002207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1203315Medicaid
IA1203315Medicaid
IA11181Medicare ID - Type Unspecified