Healthcare Provider Details
I. General information
NPI: 1811967334
Provider Name (Legal Business Name): JOHN FREDERICK HARB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/26/2006
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
39000 7 MILE RD STE 2500
LIVONIA MI
48152-1006
US
IV. Provider business mailing address
39000 7 MILE RD STE 2500
LIVONIA MI
48152-1006
US
V. Phone/Fax
- Phone: 734-462-5858
- Fax: 734-462-5860
- Phone: 734-462-5858
- Fax: 734-462-5860
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | JH061957 |
| License Number State | MI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: