MEDICARE: DAWN E HARRIS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	A75244	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235139189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAWN E HARRIS M.D.

Provider Business Mailing Address
First Line	:	103 PROVIDENCE MINE RD
Second Line	:	SUITE 202
City	:	NEVADA CITY
State	:	CA
Zip	:	95959-2941
Country	:	US
Telephone Number	:	530-470-8377
Fax Number	:	530-470-8906

Provider Business Practice Location Address
First Line	:	155 GLASSON WAY
Second Line	:
City	:	GRASS VALLEY
State	:	CA
Zip	:	95945-5723
Country	:	US
Telephone Number	:	530-274-6001
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/08/2007

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