Organization
MICHAEL G PHARRIS OD PC
Active
Parent organization
MICHAEL G PHARRIS OD PC
Other names
Adventure Dental, Vision and Orthodontics
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL G PHARRIS OD PC
Authorized official
DR. MICHAEL PHARRIS OD (OWNER/ OPTOMETRIST)
(719) 576-1850
Entity
Organization
Contact information
Practice address
5632 THE ALAMEDA, BALTIMORE, MD 21239-2737
(410) 435-0008
(410) 435-0444
Mailing address
15 N NEVADA AVE, COLORADO SPRINGS, CO 80903-1708
(719) 576-1850
(719) 576-1929
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
NOTAPPLICABLE
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MD
Enumeration date
04/22/2016
Last updated
07/26/2016
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