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General NPI Number Information
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NPI Number | 1437735412
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Entity Type | Individual
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Provider Name | HARRISON ROSS WERMUTH DO
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Gender | Male
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Dates
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Enumeration Date | 03/22/2021
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Last Update Date | 04/13/2025
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Provider Practice Location Address
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Address Line | 1215 E MICHIGAN AVE
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City | LANSING
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State | MI
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Zip | 48912-1896
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Country | US
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Telephone | 517-364-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1013 E 2ND ST
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City | ROYAL OAK
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State | MI
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Zip | 48067-2842
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Country | US
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Telephone | 248-762-9217
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Fax | 888-574-7413
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 5101028127
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 34.017598
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 02008198A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 331213
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License Number State | NY
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