Healthcare Provider Details

I. General information

NPI: 1679890354
Provider Name (Legal Business Name): MARGO S HARRISON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2010
Last Update Date: 09/14/2022
Certification Date: 09/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7155 E 38TH AVE
DENVER CO
80207-1630
US

IV. Provider business mailing address

5141 BROADWAY
NEW YORK NY
10034-1159
US

V. Phone/Fax

Practice location:
  • Phone: 505-944-2021
  • Fax:
Mailing address:
  • Phone: 212-932-4200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0058421
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number269826-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: