Provider Demographics
NPI:1053991034
Name:HARPER, ANDREW SHERMAN WESLEY (MMSC, PA-C)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:SHERMAN WESLEY
Last Name:HARPER
Suffix:
Gender:M
Credentials:MMSC, PA-C
Other - Prefix:
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Mailing Address - Street 1:100 THREE RIVERS DR NE STE A
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-4999
Mailing Address - Country:US
Mailing Address - Phone:706-528-9024
Mailing Address - Fax:706-528-9039
Practice Address - Street 1:100 THREE RIVERS DR NE STE A
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-4999
Practice Address - Country:US
Practice Address - Phone:706-528-9024
Practice Address - Fax:706-528-9039
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-13
Last Update Date:2022-03-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1698363A00000X
GA10946363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant