Healthcare Provider Details

I. General information

NPI: 1346256534
Provider Name (Legal Business Name): ELIZABETH H HARRIS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 CAMERON VALLEY PKWY SUITE 300
CHARLOTTE NC
28211-3546
US

IV. Provider business mailing address

4501 CAMERON VALLEY PKWY SUITE 300
CHARLOTTE NC
28211-3546
US

V. Phone/Fax

Practice location:
  • Phone: 704-302-9300
  • Fax: 704-302-9301
Mailing address:
  • Phone: 704-302-9300
  • Fax: 704-302-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: