Healthcare Provider Details

I. General information

NPI: 1407877707
Provider Name (Legal Business Name): CRAIG KURT HARRIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 12/21/2020
Certification Date: 12/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32800 LORAIN RD STE 2300
NORTH RIDGEVILLE OH
44039-3430
US

IV. Provider business mailing address

32800 LORAIN RD STE 2300
NORTH RIDGEVILLE OH
44039-3430
US

V. Phone/Fax

Practice location:
  • Phone: 440-406-5500
  • Fax: 440-406-5501
Mailing address:
  • Phone: 440-406-5500
  • Fax: 440-406-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.039753
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35039753
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35039759
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: