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1326067695

NPI Code Detail

MEDICARE: DR. JANE S HARRELL MD

MEDICARE: DR. JANE S HARRELL 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	207R00000X	Internal Medicine Physician	200200033	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00102236	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1349V	OTHER	NC	BCBS OF NC
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326067695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANE S HARRELL MD

Provider Business Mailing Address
First Line	:	1518 E 3RD ST
Second Line	:	SUITE 150
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3200
Country	:	US
Telephone Number	:	704-806-0038
Fax Number	:	704-770-3201

Provider Business Practice Location Address
First Line	:	1518 E 3RD ST
Second Line	:	SUITE 150
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-3200
Country	:	US
Telephone Number	:	704-806-0038
Fax Number	:

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

Provider Enumeration Date	:	07/18/2006
Last Update Date	:	06/05/2014

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Directions to “ DR. JANE S HARRELL MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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