Provider Demographics
NPI:1619001989
Name:HARRIS, ERIN FIELDS (MD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:FIELDS
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5370 RIDGE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0447
Practice Address - Country:US
Practice Address - Phone:704-316-1491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2020-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26940208000000X
NC200700464208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1619001989Medicaid
NC5907538Medicaid
NC1464EOtherBCBS
NC200949OtherMEDCOST
NCNCK544AMedicare PIN
NC1464EOtherBCBS
NC200949OtherMEDCOST
NC5907538Medicaid
NC1619001989Medicaid
NCNCK544EMedicare PIN