Provider Demographics
NPI:1306927850
Name:COLEY, HARRILL CHRISTOPHER (MD)
Entity type:Individual
Prefix:DR
First Name:HARRILL
Middle Name:CHRISTOPHER
Last Name:COLEY
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 1:3903 N ELM ST
Mailing Address - Street 2:STE 102
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-2878
Mailing Address - Country:US
Mailing Address - Phone:336-402-3923
Mailing Address - Fax:
Practice Address - Street 1:3903 N ELM ST
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2594
Practice Address - Country:US
Practice Address - Phone:336-288-7676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2008-002662086S0105X, 208600000X
ARE-5147208600000X, 2086S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5909024Medicaid
NC2022163Medicare PIN