Provider Demographics
NPI:1447086947
Name:HARPER, KEVIN ELLIOTT (SURGICAL ASSISTANT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:ELLIOTT
Last Name:HARPER
Suffix:
Gender:M
Credentials:SURGICAL ASSISTANT
Other - Prefix:MR
Other - First Name:MOHUMMED
Other - Middle Name:
Other - Last Name:ZAYDAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:SURGICAL ASSISTANT
Mailing Address - Street 1:3343 WITTEN CREST CT
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22310
Mailing Address - Country:US
Mailing Address - Phone:301-646-5654
Mailing Address - Fax:
Practice Address - Street 1:7503 SURRATTS RD
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-3358
Practice Address - Country:US
Practice Address - Phone:301-877-4380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant