Individual
MARIEL ANN HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
ONE DAVID N MYERS PARKWAY, BEACHWOOD, OH 44122
(216) 910-2641
(216) 910-2777
Mailing address
11100 EUCLID AVE, MAILSTOP HAN 6095, CLEVELAND, OH 44106-1716
(216) 464-6453
(216) 464-6403
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
35-055569
OH
207R00000X
Internal Medicine Physician
33055569
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
22992
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000225049
UNISON #
OH
01
—
000000537785
ANTHEM #
OH
05
—
0679663
—
OH
01
—
414975
WELLCARE #
OH
01
—
4320316
AETNA #
OH
01
—
751150
BUCKEYE #
OH
01
—
P00432289
RAILROAD MEDICARE
OH
Enumeration date
05/17/2007
Last updated
01/21/2013
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