Individual
DR. MARK S HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1234 NAPIER AVE, SAINT JOSEPH, MI 49085-2112
(269) 471-1700
(269) 471-1975
Mailing address
31 N SAINT JOSEPH AVE, NILES, MI 49120-2207
(269) 982-4862
(269) 985-4523
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301407295
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110089873
RAILROAD MEDICARE
MI
01
—
1101120021
BLUE CROSS
MI
01
—
1538397120
GROUP NPI
MI
01
—
2427250
CIGNA
MI
01
—
27-0381199
GROUP TAX ID
MI
05
—
4382664
—
MI
01
—
76-30001
PHP
MI
Enumeration date
06/29/2006
Last updated
03/07/2023
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