Healthcare Provider Details

I. General information

NPI: 1760770333
Provider Name (Legal Business Name): GREGORY HARRIS MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 06/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 HEMBY LN STE 100
GREENVILLE NC
27834-3792
US

IV. Provider business mailing address

2340 HEMBY LN STE 100
GREENVILLE NC
27834-3792
US

V. Phone/Fax

Practice location:
  • Phone: 252-317-3030
  • Fax:
Mailing address:
  • Phone: 252-317-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2014-02513
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number2014-02513
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: