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Organization
W RICHARD HARRIS MD LLC
Active
Organization
W RICHARD HARRIS MD LLC
Active
Other names
W RICHARD HARRIS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM RICHARD HARRIS MD (OWNER)
(231) 865-6428
Entity
Organization
Contact information
Practice address
4295 FARR RD, FRUITPORT, MI 49415-9753
(231) 865-6428
Mailing address
PO BOX 1148, MUSKEGON, MI 49443-1148
(231) 727-5081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301027079
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0806136201
BLUE CROSS BLUE SHIELD
MI
05
—
104233136
—
MI
Enumeration date
11/09/2007
Last updated
10/23/2008
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