Individual
WALTER DOUGLAS HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
250 NASH MEDICAL ARTS MALL, SUITE A, ROCKY MOUNT, NC 27804
(252) 937-0227
(252) 937-3105
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34343
NC
2086S0129X
Vascular Surgery Physician
34343
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10456
BCBSNC
NC
01
—
20024902
RAILROAD MEDICARE
NC
01
—
42423
MEDCOST
NC
01
—
6109936
CIGNA HEALTHCARE
NC
05
—
8940156
—
NC
Enumeration date
09/08/2005
Last updated
03/30/2015
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