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Individual

BRIAN NEAL HARRIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
(671) 645-5549
Mailing address
133 ROUTE 3, DEDEDO, GU 96929-6911
(671) 645-5500
(671) 645-5549

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G78320
CA
207P00000X
Emergency Medicine Physician
Primary
M-2030
GU

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G783200
BLUE SHIELD
CA
01
930032604
RAILROAD
CA
Enumeration date
08/02/2006
Last updated
02/02/2017
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