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General NPI Number Information
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NPI Number | 1063706141
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Entity Type | Organization
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Legal Business Name | DAVID K HARRIS MD PC
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Dates
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Enumeration Date | 06/06/2011
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Last Update Date | 06/20/2011
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Provider Practice Location Address
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Address Line | 19500 MIDDLEBELT RD SUITE 350E
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City | LIVONIA
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State | MI
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Zip | 48152-2196
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Country | US
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Telephone | 248-477-0110
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Fax | 248-477-0111
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Provider Business Mailing Address
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Address Line | 19500 MIDDLEBELT RD SUITE 350E
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City | LIVONIA
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State | MI
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Zip | 48152-2196
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Country | US
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Telephone | 248-477-0110
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Fax | 248-477-0111
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | DR. DAVID HARRIS
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Credential | M.D.
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Telephone | 248-477-0110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 4301060044
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License Number State | MI
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