Individual
PAUL D HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
310 LAFAYETTE AVE SE, STE 415, GRAND RAPIDS, MI 49503-4693
(616) 685-5666
Mailing address
245 STATE ST SE, STE 228, GRAND RAPIDS, MI 49503-4328
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101012300
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
5101012300
MI
207RP1001X
Pulmonary Disease Physician
Primary
5101012300
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4306439
—
MI
05
—
4877939
—
MI
Enumeration date
07/12/2006
Last updated
07/14/2011
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