Provider Demographics
NPI:1780699116
Name:HARVEY, ALAN M (MD, MBA)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:M
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16087
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2787
Mailing Address - Country:US
Mailing Address - Phone:912-429-9020
Mailing Address - Fax:912-352-0793
Practice Address - Street 1:1139 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-5502
Practice Address - Country:US
Practice Address - Phone:912-429-9020
Practice Address - Fax:912-352-0793
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0075136207L00000X
MA50701207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3027805Medicaid
MAJ02354Medicare UPIN