Provider Demographics
NPI:1487711552
Name:LI, HARRY (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:LI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:HUAIBIN
Other - Middle Name:
Other - Last Name:LI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8600 SNOWDEN RIVER PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-1982
Mailing Address - Country:US
Mailing Address - Phone:410-312-4700
Mailing Address - Fax:410-312-0400
Practice Address - Street 1:8600 SNOWDEN RIVER PKWY
Practice Address - Street 2:SUITE 301
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1982
Practice Address - Country:US
Practice Address - Phone:410-312-4700
Practice Address - Fax:410-312-0400
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0056531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF9910001OtherBCBS FEP
MD2870319OtherAETNA HMO
MD7154906001OtherCIGNA HMO
MD61215502OtherBCBS ID
MD7154906002OtherCIGNA PPO
MD7423243OtherAETNA PPO
MDH39432Medicare UPIN
MD7423243OtherAETNA PPO