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General NPI Number Information
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NPI Number | 1023180031
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Entity Type | Organization
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Legal Business Name | CRAIG D HARRIS MD PA
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 310 N GUM ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6874
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Country | US
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Telephone | 843-873-5606
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Fax | 843-873-8861
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Provider Business Mailing Address
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Address Line | 310 N GUM ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6874
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Country | US
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Telephone | 843-873-5606
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Fax | 843-873-8861
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | CRAIG DYER HARRIS
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Credential | MD
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Telephone | 846-873-5606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | 16635
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 16635
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License Number State | SC
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