Individual
THOMAS STANLEY HARLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
16281
NC
2085R0202X
Diagnostic Radiology Physician
16281
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093V
BCBS
NC
01
—
21380
PARTNERS
NC
05
—
220626000
—
WV
01
—
5042652
AETNA
NC
05
—
7217617
—
VA
01
—
76114
MEDCOST
NC
05
—
891093V
—
NC
05
—
Q16281
—
SC
Enumeration date
12/01/2005
Last updated
10/08/2010
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