Individual
MICHAEL W HARRIS
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
425 TIOGA AVE, KINGSTON, PA 18704-5624
(570) 288-6543
Mailing address
425 TIOGA AVE, KINGSTON, PA 18704-5624
(570) 288-6543
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
MD022597E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0710598
—
PA
Enumeration date
03/01/2006
Last updated
07/08/2007
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