Individual
DR. PETER MARSHALL HARVEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
1612 10TH ST, WICHITA FALLS, TX 76301-4307
(940) 723-1054
(940) 723-4646
Mailing address
1612 10TH ST, WICHITA FALLS, TX 76301-4307
(940) 723-1054
(940) 723-4646
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
346
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000826001
—
TX
01
—
00F621
BLUE CROSS BLUE SHIELD
TX
01
—
0346
STATE LICENSE NUMBER
TX
01
—
482039423
MEDICAID DMERC NUMBER
TX
Enumeration date
06/21/2005
Last updated
11/08/2007
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