Harries, Larry Dean
Harries, Larry Dean is an sole proprietor health care provider with primary practice located at 307 St Johns Way Ste 4, Lewiston ID 83501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Harries, Larry Dean can be contacted via phone (208) 743-8585.Contact Information
Primary practice address
307 St Johns Way Ste 4
Lewiston ID 83501
Phone: (208) 743-8585
Fax: (208) 743-0118
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M3129 | Idaho |
Profile Details
| NPI number | 1033105994 |
|---|---|
| LBN Legal business name | Harries, Larry Dean |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2005 |
| Last updated | Jun 24th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033105994 | NPPES |
| Idaho | MEDICAID | 000226400 |
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