Individual
DR. CLYDE L HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2131 S 17TH ST, WILMINGTON, NC 28401-7407
(910) 815-5830
(910) 815-5698
Mailing address
PO BOX 602484, CHARLOTTE, NC 28260-2484
(910) 815-5830
(910) 815-5698
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
28415
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8939871
—
NC
05
—
Q28415
—
SC
Enumeration date
07/18/2006
Last updated
08/26/2014
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