MEDICARE: STEPHEN HARRISON DO PC

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	207Q00000X	Family Medicine Physician	5101015283	MI

General Provider Information

NPI Number	:	1528234929
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STEPHEN HARRISON DO PC

Provider Business Mailing Address
First Line	:	8143 S SAGINAW ST
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1825
Country	:	US
Telephone Number	:	810-694-0300
Fax Number	:	810-694-8013

Provider Business Practice Location Address
First Line	:	8143 S SAGINAW ST
Second Line	:
City	:	GRAND BLANC
State	:	MI
Zip	:	48439-1825
Country	:	US
Telephone Number	:	810-694-0300
Fax Number	:	810-694-8013

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHEN R HARRISON
Credential	:	DO
Telephone Number	:	810-694-0300

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	04/25/2012

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