MEDICARE: ASHLEY ELIZABETH HARTE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	31925	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184851727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY ELIZABETH HARTE M.D.

Provider Business Mailing Address
First Line	:	822 COLDWATER CREEK CIR
Second Line	:
City	:	NICEVILLE
State	:	FL
Zip	:	32578-1658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	901 W GREENWOOD ST
Second Line	:	SUITE 9
City	:	ABBEVILLE
State	:	SC
Zip	:	29620-5717
Country	:	US
Telephone Number	:	864-366-9681
Fax Number	:	864-366-5600

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2009
Last Update Date	:	12/14/2018

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