# AVVERAHALLI HARISH MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124208129
- **Authorized official:** AVVERAHALLI M HARISH MD (PRESIDENT)
- **Authorized official phone:** (410) 655-0312

## Contact information

- **Practice address:** 5310 OLD COURT ROAD SUITE 303, RANDALLSTOWN, MD 21133-6202
- **Practice address phone:** (410) 655-0312
- **Practice address fax:** (410) 655-0497
- **Mailing address:** 5310 OLD COURT ROAD SUITE 303, RANDALLSTOWN, MD 21133-6202
- **Mailing address phone:** (410) 655-0312
- **Mailing address fax:** (410) 655-0497

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | D42723 | MD | Yes |

## Other

- **Enumeration date:** 11/07/2007
- **Last updated:** 11/07/2007