Provider Demographics
NPI:1629064936
Name:HARMON, BETTY JEAN (MD)
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:JEAN
Last Name:HARMON
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 1:2355 HEMBY LN
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-3776
Mailing Address - Country:US
Mailing Address - Phone:252-321-8474
Mailing Address - Fax:252-695-6177
Practice Address - Street 1:2355 HEMBY LN
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-3776
Practice Address - Country:US
Practice Address - Phone:252-321-8474
Practice Address - Fax:252-695-6177
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000445207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1259JOtherBCBS
NC891259JMedicaid
NC1259JOtherBCBS
NC2280226AMedicare ID - Type Unspecified