Individual
MARK STEVEN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1123 SOUTH RD, BRADFORD, VT 05033-8803
(802) 272-2674
Mailing address
331 UPPER PLAIN, BRADFORD, VT 05033
(802) 222-4722
(802) 222-4709
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
006039
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0004689
—
VT
01
—
030367834
TAX ID
—
05
—
99004689
—
NH
Enumeration date
11/20/2006
Last updated
09/09/2019
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