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Individual

JOHN W HARLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 MARILYN AVE, SUITE 4, GOSHEN, IN 46526-4800
(574) 533-2769
(574) 534-6822
Mailing address
101 MARILYN AVE, SUITE 4, GOSHEN, IN 46526-4800
(574) 533-2769
(574) 534-6822

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
31690
IN
2086S0129X
Vascular Surgery Physician
Primary
31690
IN

Other

Enumeration date
11/17/2005
Last updated
01/08/2008
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