Healthcare Provider Details

I. General information

NPI: 1619920378
Provider Name (Legal Business Name): TIMOTHY EDWARD HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 NEW BERN AVE
RALEIGH NC
27610
US

IV. Provider business mailing address

3009 NEW BERN AVE
RALEIGH NC
27610
US

V. Phone/Fax

Practice location:
  • Phone: 919-232-5020
  • Fax: 919-232-5021
Mailing address:
  • Phone: 919-232-5020
  • Fax: 919-232-5021

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: