Individual
RICHARD S HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
550 MIRABEAU ST, GREENFIELD, OH 45123-1617
(937) 981-2116
(937) 981-9238
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4231
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34004098H
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000319610
BLUE CROSS BLUE SHIELD
—
05
—
0631990
—
OH
Enumeration date
05/04/2006
Last updated
10/19/2007
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