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NPI Code Detail

MEDICARE: MICHELLE R HARRISON M.D.

MEDICARE:   MICHELLE R HARRISON  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
1207V00000XObstetrics & Gynecology Physician01049107AIN
2207V00000XObstetrics & Gynecology Physician04-49028KS

Other Identifiers

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

General Provider Information

NPI Number : 1710973128
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE R HARRISON M.D.
Provider Business Mailing Address
First Line : 11109 PARKVIEW PLAZA DR # 117
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1701
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 310 E WALNUT ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-5572
Country : US
Telephone Number : 620-275-9752
Fax Number : 620-275-4306
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 02/10/2026

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Directions to “ MICHELLE R HARRISON M.D.” Practice Location

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