Provider Demographics
NPI:1053372367
Name:YFANTIS, HARRIS G (MD)
Entity type:Individual
Prefix:DR
First Name:HARRIS
Middle Name:G
Last Name:YFANTIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10 N GREENE ST
Mailing Address - Street 2:BALTIMORE VA DEPARTMENT OF PATHOLOGY 4D-140
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-1524
Mailing Address - Country:US
Mailing Address - Phone:410-605-7000
Mailing Address - Fax:410-605-7911
Practice Address - Street 1:10 N GREENE ST
Practice Address - Street 2:BALTIMORE VA DEPARTMENT OF PATHOLOGY 4D-140
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1524
Practice Address - Country:US
Practice Address - Phone:410-605-7000
Practice Address - Fax:410-605-7911
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2008-12-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0057786174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist