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General NPI Number Information
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NPI Number | 1386668234
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Entity Type | Individual
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Provider Name | RICHARD EUGENE HAIRE PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 75 EMERSON BAY RD STE 102
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City | CAROLINA SHORES
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State | NC
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Zip | 28467-2498
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Country | US
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Telephone | 910-579-8363
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Fax | 910-579-8306
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone | 910-579-8363
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Fax | 910-579-8306
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA00194
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2160
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-08101
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License Number State | NC
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