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General NPI Number Information
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NPI Number | 1659397339
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Entity Type | Individual
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Provider Name | HARIS C. MACRIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 18723 AUDETTE ST
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City | DEARBORN
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State | MI
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Zip | 48124-4274
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Country | US
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Telephone | 313-359-2775
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Fax |
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Provider Business Mailing Address
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Address Line | 33155 ANNAPOLIS AVE OAKWOOD FAMILY MEDICINE RESIDENCY PROGRAM
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City | WAYNE
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State | MI
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Zip | 48184
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Country | US
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Telephone | 734-467-2483
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301084245
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License Number State | MI
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