Individual
DR. WILLIAM MICHAEL HARRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11950 MACCORKLE AVE, CHESAPEAKE, WV 25315-1135
(304) 220-2111
(304) 220-2183
Mailing address
66 DUTCH RIDGE RD, CLENDENIN, WV 25045-9528
(304) 968-3033
(304) 968-3103
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1320
WV
207R00000X
Internal Medicine Physician
Primary
1320
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001316637
WV BCBS
WV
05
—
0077610000
—
WV
01
—
1056879
WV DWC
WV
01
—
5530031
AETNA
WV
01
—
P00030193
CH1 RAILROAD MEDICARE
WV
01
—
P00059183
CH2 RAILROAD MEDICARE
WV
Enumeration date
12/30/2005
Last updated
06/18/2019
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