W Richard Harris | |
4295 Farr Rd Fruitport MI 49415-9753 | |
(231) 865-6428 | |
Not Available |
Full Name | W Richard Harris |
---|---|
Speciality | Family Medicine |
Location | 4295 Farr Rd, Fruitport, Michigan |
Authorized Official Name and Position | William Richard Harris (OWNER) |
Authorized Official Contact | 2318656428 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
W Richard Harris Po Box 1148 Muskegon MI 49443-1148 Ph: (231) 727-5081 | W Richard Harris 4295 Farr Rd Fruitport MI 49415-9753 Ph: (231) 865-6428 |
NPI Number | 1770763443 |
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Provider Enumeration Date | 11/09/2007 |
Last Update Date | 10/23/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770763443 | NPI | - | NPPES |
0806136201 | Other | MI | BLUE CROSS BLUE SHIELD |
104233136 | Medicaid | MI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301027079 (Michigan) | Primary |
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