Provider Demographics
NPI:1912999111
Name:HARSCH, RICHARD HENRY (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HENRY
Last Name:HARSCH
Suffix:
Gender:M
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 19305
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28219-9305
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2090 S US 29 HWY
Practice Address - Street 2:
Practice Address - City:CHINA GROVE
Practice Address - State:NC
Practice Address - Zip Code:28023-8650
Practice Address - Country:US
Practice Address - Phone:704-403-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911565Medicaid
NC1912999111Medicaid
NCG79400Medicare UPIN
NCNCD637AMedicare PIN
NCNCD637BMedicare PIN
NC2262765Medicare PIN
NC2285883Medicare PIN