Provider Demographics
NPI:1588555213
Name:HARPER, ALPHONSO LAWAYNE
Entity type:Individual
Prefix:
First Name:ALPHONSO
Middle Name:LAWAYNE
Last Name:HARPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8813 LIBERTY RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4209
Mailing Address - Country:US
Mailing Address - Phone:202-763-2354
Mailing Address - Fax:
Practice Address - Street 1:595 ELK DR # 1430
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-1632
Practice Address - Country:US
Practice Address - Phone:202-763-2354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver