Provider Demographics
NPI:1750617338
Name:HARVEY, PAUL MICHAEL (MA,CCC-A)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:MICHAEL
Last Name:HARVEY
Suffix:
Gender:M
Credentials:MA,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:984 FIRST COLONIAL RD
Mailing Address - Street 2:STE 302
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-3196
Mailing Address - Country:US
Mailing Address - Phone:757-472-5733
Mailing Address - Fax:
Practice Address - Street 1:984 FIRST COLONIAL RD
Practice Address - Street 2:STE 302
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-3196
Practice Address - Country:US
Practice Address - Phone:757-472-5733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201000166231H00000X
VA2102002474237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter