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Individual

DR. MARTIN HARRIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-3000
Mailing address
6033 COWELL RD, BRIGHTON, MI 48116-9109
(248) 849-3485

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
4301049889
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103374784
MI
05
104274916
MI
05
104288644
MI
01
MH049889
BC/BS OF MICHIGAN
MI
Enumeration date
06/09/2006
Last updated
04/24/2017
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