MEDICARE: DR. ROBERT MARK HARRIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	21790	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295844959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT MARK HARRIS MD

Provider Business Mailing Address
First Line	:	2260 S CHURCH ST STE 303
Second Line	:	GREATER BURLINGTON MENTAL HEALTH SERVICES, EASTER SEALS
City	:	BURLINGTON
State	:	NC
Zip	:	27215-5389
Country	:	US
Telephone Number	:	336-585-1737
Fax Number	:	336-585-9540

Provider Business Practice Location Address
First Line	:	2260 S CHURCH ST STE 303
Second Line	:	GREATER BURLINGTON MENTAL HEALTH SERVICES, EASTER SEALS
City	:	BURLINGTON
State	:	NC
Zip	:	27215-5389
Country	:	US
Telephone Number	:	336-585-1737
Fax Number	:	336-585-9540

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	08/20/2011

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