Provider Demographics
NPI:1184773970
Name:HARSH, SHIV KUMAR (M D)
Entity type:Individual
Prefix:DR
First Name:SHIV
Middle Name:KUMAR
Last Name:HARSH
Suffix:
Gender:M
Credentials:M D
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 2028
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27204-2028
Mailing Address - Country:US
Mailing Address - Phone:336-629-4176
Mailing Address - Fax:336-626-6604
Practice Address - Street 1:542 WHITE OAK ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4710
Practice Address - Country:US
Practice Address - Phone:336-629-4176
Practice Address - Fax:336-626-6604
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30361207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8940155Medicaid
NC207071Medicare ID - Type Unspecified
NCC84372Medicare UPIN