Provider Demographics
NPI:1316489131
Name:HARMAN, BRETT (PA-C)
Entity type:Individual
Prefix:
First Name:BRETT
Middle Name:
Last Name:HARMAN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BEE ST
Mailing Address - Street 2:APT 311
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-5701
Mailing Address - Country:US
Mailing Address - Phone:443-789-4326
Mailing Address - Fax:
Practice Address - Street 1:9100 MEDCOM ST
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9167
Practice Address - Country:US
Practice Address - Phone:843-569-3367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2667363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical