DR. HARISH MARISIDDAIAH (NPI# 1073500765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073500765 |
| Entity Type | Individual |
| Full Name | DR. HARISH MARISIDDAIAH |
| Credential | M.D. |
| Practice Address |
2711 X Ray Dr Gastonia NC 28054-7491 |
| Mailing Address |
2240 Remount Rd Gastonia NC 28054-4725 |
| Practice Telephone | 7048342465 |
| Practice Fax Number | 7048342466 |
| Mailing Telephone | 7046715311 |
| Mailing Fax Number | 7046715308 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-09-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
9500993 | NC | Allopathic & Osteopathic Physicians |
| Y | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
MD61064980 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | N00993 | 05 | |
| NC | 8954784 | 05 |
| Street Address |
2711 X RAY DR |
| City | GASTONIA |
| State | NC |
| Zip Code | 28054-7491 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910547 | Devon Cook | Nurse Practitioner | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2020-10-26 |
| 1134699267 | Jordan Ashley Clayton | Nurse Practitioner | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2018-12-02 |
| 1003106162 | Caromont Medical Group Inc | Surgery | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2011-04-11 |
| 1871899898 | Caromont Medical Group Inc | Family Medicine | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2011-02-09 |
| 1427361237 | Thomas Henry | Pharmacist | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2010-07-21 |
| 1013248491 | Jasmine Sicilia Stone | Physician Assistant | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2010-01-25 |
| 1538340559 | Caromont Medical Group Inc | Family Medicine | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2007-11-19 |
| 1356469555 | Abhijeet Shripad Nadkarni | Internal Medicine | 2711 X Ray Dr, Suite 3700, Gastonia, NC 28054-7491 | 2007-03-26 |
| 1184706806 | Dalena Mae Custer | Physician Assistant | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2006-10-20 |
| 1396732707 | Manu Hira Patel | Family Medicine | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2005-09-30 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225671423 | Michaela Karsyn Morris | Behavioral Analyst | 2875 Court Dr. B, Gastonia, NC 28054 | 2019-10-21 |
| 1982263810 | Brenda Sue Fox | Occupational Therapist | Brian Center, 969 Cox Rd, Gastonia, NC 28054 | 2019-06-13 |
| 1174096911 | Carolinas Hometown Respiratory LLC | Durable Medical Equipment & Medical Supplies | 469 Hospital Drive, Suite B1, Gastonia, NC 28054 | 2019-01-04 |
| 1255801817 | Jarae Mcswain | Counselor | 1558 Union Road, Ste F, Gastonia, NC 28054 | 2018-11-27 |
| 1427549807 | Alterman & Dhillon Charlotte Metro, Pplc | Dentist | 2205 E. Franklin Blvd, Ste 110, Gastonia, NC 28054 | 2018-05-22 |
| 1871083147 | Terrence Lamont Campbell | Dentist | 2641 Court Dr Ste A, Gastonia, NC 28054 | 2018-05-13 |
| 1861995367 | Jefferson and Jefferson LLC. | Respite Care | 945 East 6 Ave, Gastonia, NC 28054 | 2018-03-12 |
| 1790154912 | Tyler Adcock | Pharmacist | 2324 South New Hope Rd, Gastonia, NC 28054 | 2015-09-17 |
| 1922481894 | Alesha Nicole Logan | Nurse Practitioner | 1895 Hoffman Rd Ste A, Gastonia, NC 28054 | 2015-07-09 |
| 1457732596 | Buffie Baker Eller | Counselor | 2005 Flint Lane, Gastonia, NC 28054 | 2015-06-15 |
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| Taxonomy Code | 207RI0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Infectious Disease |
| An internist who deals with infectious diseases of all types and in all organ systems. Conditions requiring selective use of antibiotics call for this special skill. This physician often diagnoses and treats AIDS patients and patients with fevers which have not been explained. Infectious disease specialists may also have expertise in preventive medicine and travel medicine. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568643583 | Caromont Medical Group, Inc. | Internal Medicine | 2555 Court Dr Ste 350, Gastonia, NC 28054-2186 | 2007-11-19 |
| 1780671479 | Randall D. Marosok | Internal Medicine | 660 Summit Crossing Pl, Suite 306, Gastonia, NC 28054-2104 | 2005-09-29 |
| 1891782504 | Mark Allen Nesky | Internal Medicine | 2711 X Ray Dr, Gastonia, NC 28054-7491 | 2005-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013419316 | Novant Medical Group, Inc. | Internal Medicine | 1450 Matthews Township Parkway Ste 280, Matthews, NC 28105-5331 | 2018-03-02 |
| 1023518909 | Stephanie Nicole Dixon | Internal Medicine | 301 E Wendover Ave Ste 111, Greensboro, NC 27401-1209 | 2018-02-16 |
| 1003332016 | Novant Medical Group Inc | Internal Medicine | 10030 Gilead Rd Ste 344, Huntersville, NC 28078-7545 | 2017-08-22 |
| 1003202268 | Heather Root | Internal Medicine | 2118b Bioinformatics Building 130 Mason Farm Rd Cb 7030, Chapel Hill, NC 27599 | 2015-04-14 |
| 1689064396 | Michael Sciaudone | Internal Medicine | 130 Mason Farm Rd Cb 7030, 2115 Bioinformatics Building, Chapel Hill, NC 27599 | 2015-02-02 |
| 1790198596 | Robert C Pease | Internal Medicine | William B Aycock Bldg 590 Manning Drive Cb 7595, Chapel Hill, NC 27599 | 2014-06-09 |
| 1447698089 | Emily Jane Ciccone | Internal Medicine | 230 Macnider Hl, Cb#7593, Chapel Hill, NC 27599-0001 | 2013-06-05 |
| 1255694626 | Carlos A. Duchesne | Internal Medicine | 8505 Waterchase Ct, Raleigh, NC 27613-6273 | 2012-06-20 |
| 1619243037 | Nicholas Andrew Turner | Internal Medicine | 40 Duke Medicine Cir # 1k, Durham, NC 27710-6155 | 2012-03-29 |
| 1780977215 | Erin Whitney Barnes | Internal Medicine | Section of Infectious Disease, Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2011-05-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.