Organization
ANGELA L. HARRIS, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA LENELL HARRIS M.D. (OWNER)
(313) 586-7400
Entity
Organization
Contact information
Practice address
2950 W OUTER DR, DETROIT, MI 48221-1750
(313) 586-7400
(313) 221-9124
Mailing address
PO BOX 21893, DETROIT, MI 48221-0893
(313) 586-7400
(313) 221-9124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301058258
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080H237420
BCBSM
MI
01
—
1363702
FIRST HEALTH PLAN
—
01
—
211296
ONE HEALTH PLAN/ GREAT-WEST HEALTHCARE
—
05
—
3395292
—
MI
01
—
5717471
AETNA
—
Enumeration date
06/26/2005
Last updated
01/01/2013
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