Basic Information
| Provider Information | |||||||||
| NPI: | 1972582294 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HARPER | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | A. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2150 W CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436063846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192912192 | ||||||||
| FaxNumber: | 4194793297 | ||||||||
| Practice Location | |||||||||
| Address1: | 2150 W CENTRAL AVE | ||||||||
| Address2: | |||||||||
| City: | TOLEDO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 436063846 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4192912192 | ||||||||
| FaxNumber: | 4194793297 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/13/2006 | ||||||||
| LastUpdateDate: | 09/08/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 35-061789H | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 0938169 | 05 | OH | MEDICAID | 4367083 | 01 | AETNA | OTHER | 46601 | 01 | HEALTH PLAN OF MICHIGAN | OTHER | 000000536702 | 01 | ANTHEM | OTHER | 000000536672 | 01 | ANTHEM | OTHER | 05248 | 01 | PARAMOUNT | OTHER |