Individual
DONALD D HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
17978 SR 55, BAKER, WV 26801
(304) 897-5915
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
01128
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001777408
MS BCBS
WV
05
—
3810003569
—
WV
Enumeration date
12/05/2005
Last updated
05/05/2015
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