Provider Demographics
NPI:1831226158
Name:CHAD HARVEY MD PA
Entity type:Organization
Organization Name:CHAD HARVEY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-287-2191
Mailing Address - Street 1:900 SE OCEAN BLVD
Mailing Address - Street 2:SUITE F150
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2471
Mailing Address - Country:US
Mailing Address - Phone:772-287-2191
Mailing Address - Fax:772-287-9808
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:SUITE F150
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-287-2191
Practice Address - Fax:772-287-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0055456207R00000X, 207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
08911YMedicare ID - Type Unspecified
U32417Medicare UPIN
U6302YMedicare ID - Type Unspecified
K9327Medicare ID - Type Unspecified
5606670001Medicare ID - Type UnspecifiedPALMETTO
C16688Medicare UPIN