Individual
MICHAEL HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
311 W 14TH ST, PUEBLO, CO 81003-2705
(719) 595-7585
(719) 595-7982
Mailing address
311 W 14TH ST, PUEBLO, CO 81003-2705
(719) 595-7585
(719) 595-7982
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TL0006413
CO
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
03/14/2017
Last updated
09/27/2018
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