Individual
DR. HARISH MARISIDDAIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2711 X RAY DR, GASTONIA, NC 28054-7491
(704) 834-2465
(704) 834-2466
Mailing address
2240 REMOUNT RD, GASTONIA, NC 28054-4725
(704) 671-5311
(704) 671-5308
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
9500993
NC
207RI0200X
Infectious Disease Physician
Primary
MD61064980
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8954784
—
NC
05
—
N00993
—
SC
Enumeration date
09/29/2005
Last updated
09/03/2020
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