Basic Information
| Provider Information | |||||||||
| NPI: | 1235222431 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARRIS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | ALAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1414 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284017505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107637363 | ||||||||
| FaxNumber: | 9102518296 | ||||||||
| Practice Location | |||||||||
| Address1: | 1414 MEDICAL CENTER DR | ||||||||
| Address2: | |||||||||
| City: | WILMINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 284017505 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9107637363 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2006 | ||||||||
| LastUpdateDate: | 04/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 2001-00887 | NC | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 020050027 | 01 | NC | RAILROAD MEDICARE INDV. # | OTHER | 129VE | 01 | NC | BCBS OF NC INDV. # | OTHER | 2115030 | 01 | NC | INDV. UNITED HEALTHCARE # | OTHER | 89129VE | 05 | NC | MEDICAID |