Provider Demographics
NPI:1003963141
Name:HARRIS, KATARINA (MD)
Entity Type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATARINA
Other - Middle Name:
Other - Last Name:SLYNKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 SAINT FRANCIS DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-3971
Mailing Address - Country:US
Mailing Address - Phone:864-233-8063
Mailing Address - Fax:864-233-2438
Practice Address - Street 1:3 SAINT FRANCIS DR
Practice Address - Street 2:SUITE 300
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-3971
Practice Address - Country:US
Practice Address - Phone:864-233-8063
Practice Address - Fax:864-233-2438
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2006-01760207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC195314OtherMEDCOST
NC144MNOtherBCBS OF NC
SC296478Medicaid
NC5905647Medicaid
NC2060714Medicare PIN
SC296478Medicaid
NC5905647Medicaid