Provider Demographics
NPI:1518143460
Name:FRANK, HARRISON GABRIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRISON
Middle Name:GABRIEL
Last Name:FRANK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1630 MILITARY CUTOFF RD
Mailing Address - Street 2:#104
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-5719
Mailing Address - Country:US
Mailing Address - Phone:910-679-8534
Mailing Address - Fax:910-679-8535
Practice Address - Street 1:1630 MILITARY CUTOFF RD
Practice Address - Street 2:#104
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-5719
Practice Address - Country:US
Practice Address - Phone:910-679-8534
Practice Address - Fax:910-679-8535
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-10
Last Update Date:2017-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2011-01636208100000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918505Medicaid
NC5918505Medicaid