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Individual

PETER HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
042.0007993
VT
207R00000X
Internal Medicine Physician
0420007993
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00028804
BLUE SHIELD
VT
05
0009470
VT
01
110137555
RAILROAD MEDICARE
VT
05
3008260
NH
01
8000217
LADIES FIRST
VT
01
810628
MVP
VT
Enumeration date
08/30/2006
Last updated
06/17/2015
Update your record

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