Provider Demographics
NPI:1205091253
Name:HARBERT, RONALD ALAN
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:ALAN
Last Name:HARBERT
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 1:349 FOLLY RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-2508
Mailing Address - Country:US
Mailing Address - Phone:843-795-7917
Mailing Address - Fax:843-762-7898
Practice Address - Street 1:349 FOLLY RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2508
Practice Address - Country:US
Practice Address - Phone:843-795-7917
Practice Address - Fax:843-762-7898
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC415156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician