Provider Demographics
NPI:1770551020
Name:FITE, HAROLD (PA)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:
Last Name:FITE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 LATROBE DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-4849
Mailing Address - Country:US
Mailing Address - Phone:704-867-0735
Mailing Address - Fax:704-867-0738
Practice Address - Street 1:660 SUMMIT CROSSING PL
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-2104
Practice Address - Country:US
Practice Address - Phone:704-867-0735
Practice Address - Fax:704-867-0738
Is Sole Proprietor?:No
Enumeration Date:2006-03-12
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC101031363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S84228Medicare UPIN
NC2751476AMedicare ID - Type UnspecifiedMEDICARE