Provider Demographics
NPI:1881633915
Name:HARRIS, PETER K (DC)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2616 PHILADELPHIA PIKE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CLAYMONT
Mailing Address - State:DE
Mailing Address - Zip Code:19703
Mailing Address - Country:US
Mailing Address - Phone:302-792-1900
Mailing Address - Fax:302-792-0118
Practice Address - Street 1:2616 PHILADELPHIA PIKE
Practice Address - Street 2:SUITE B
Practice Address - City:CLAYMONT
Practice Address - State:DE
Practice Address - Zip Code:19703-2520
Practice Address - Country:US
Practice Address - Phone:302-792-1900
Practice Address - Fax:302-792-0118
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1 0000437111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEU68395Medicare UPIN