Provider Demographics
NPI:1538263264
Name:HARISH KHER MD PA
Entity type:Organization
Organization Name:HARISH KHER MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:
Authorized Official - Last Name:KHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:386-257-4777
Mailing Address - Street 1:601 N CLYDE MORRIS BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114
Mailing Address - Country:US
Mailing Address - Phone:386-257-4777
Mailing Address - Fax:386-257-4776
Practice Address - Street 1:601 N CLYDE MORRIS BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114
Practice Address - Country:US
Practice Address - Phone:386-257-4777
Practice Address - Fax:386-257-4776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME429462084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL275939000Medicaid
FL040772100Medicaid
K9821Medicare ID - Type Unspecified
FL275939000Medicaid