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NPI Code Detail

MEDICARE: DR. ROBERT L HARRELL

MEDICARE: DR. ROBERT L HARRELL
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
1122300000XDentist6675NC

General Provider Information

NPI Number : 1437353711
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT L HARRELL
Provider Business Mailing Address
First Line : 7820 BALLANTYNE COMMONS PKWY STE 102
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2889
Country : US
Telephone Number : 704-541-9888
Fax Number : 704-541-7944
Provider Business Practice Location Address
First Line : 7820 BALLANTYNE COMMONS PKWY STE 102
Second Line :
City : CHARLOTTE
State : NC
Zip : 28277-2889
Country : US
Telephone Number : 704-541-9888
Fax Number : 704-541-7944
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2007
Last Update Date : 09/10/2007

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