Individual
KENNETH O HARRIS SR.
Active
Individual
KENNETH O HARRIS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
58821
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110207599
MEDICARE RAILRAOD
MA
01
—
30111
PILGRIM
MA
05
—
3077706
—
MA
01
—
703629
SECURE HORIZONS
MA
01
—
730629
TUFTS
MA
01
—
HAJ08079
BLUE SHIELD
MA
Enumeration date
07/11/2006
Last updated
10/25/2007
Update your record
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