Basic Information
Provider Information
NPI: 1285634659
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARTER
FirstName: STEVEN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6355 S BUFFALO DR FL 3
Address2:  
City: LAS VEGAS
State: NV
PostalCode: 891132133
CountryCode: US
TelephoneNumber: 7022163346
FaxNumber: 7029212419
Practice Location
Address1: 6850 N DURANGO DR
Address2: #310
City: LAS VEGAS
State: NV
PostalCode: 891494595
CountryCode: US
TelephoneNumber: 7022553547
FaxNumber: 7023965585
Other Information
ProviderEnumerationDate: 07/28/2005
LastUpdateDate: 11/02/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/02/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207V00000X9328NVY Allopathic & Osteopathic PhysiciansObstetrics & Gynecology 

ID Information
IDTypeStateIssuerDescription
00201849605NV MEDICAID


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