Individual
BARON DWAYNE HARPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
401 I ST, SUITE A, MARYSVILLE, CA 95901-5626
(530) 743-5125
(530) 743-4528
Mailing address
401 I ST, SUITE A, MARYSVILLE, CA 95901-5626
(530) 743-5125
(530) 743-4528
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036088122
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G88253
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G882530
BLUE SHIELD PIN #
CA
01
—
020021894
RAILROAD MEDICARE
—
05
—
036088122
—
IL
05
—
1588695902
—
CA
05
—
32030700
—
WI
01
—
P00659512
RAILROAD MEDICARE
CA
Enumeration date
07/05/2006
Last updated
06/19/2014
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