Healthcare Provider Details

I. General information

NPI: 1427269034
Provider Name (Legal Business Name): NORMAN OLIVER HARRISON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7733 E JEFFERSON AVE
DETROIT MI
48214-3707
US

IV. Provider business mailing address

51194 E VILLAGE RD #308
CHESTERFIELD MI
48047-1366
US

V. Phone/Fax

Practice location:
  • Phone: 313-499-4900
  • Fax:
Mailing address:
  • Phone: 586-949-9096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PH0002X
TaxonomyHospice and Palliative Medicine (Emergency Medicine) Physician
License Number4301066175
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: