| W Richard Harris Md Llc | |
|
4295 Farr Rd Fruitport MI 49415-9753 | |
| (231) 865-6428 | |
| Not Available |
| Full Name | W Richard Harris Md Llc |
|---|---|
| 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 Md Llc Po Box 1148 Muskegon MI 49443-1148 Ph: (231) 727-5081 | W Richard Harris Md Llc 4295 Farr Rd Fruitport MI 49415-9753 Ph: (231) 865-6428 |
| NPI Number | 1770763443 |
|---|---|
| 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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