Harris, Stephen D

Harris, Stephen D is an individual health care provider with primary practice located at 3260 Eagle Park Dr Ne Suite 116, Grand Rapids MI 49525-4569. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery, which is considered as his primary health care specialty. Harris, Stephen D can be contacted via phone (616) 957-2088.

Contact Information

Primary practice address
3260 Eagle Park Dr Ne Suite 116 Grand Rapids MI 49525-4569
Phone: (616) 957-2088
Fax: (855) 665-5636
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 5901001348 Michigan

Profile Details

NPI number 1598760001
LBN Legal business name Harris, Stephen D
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2005
Last updated Nov 10th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1598760001 NPPES
Michigan Other 4853950100 BLUE CROSS BLUE SHIELD #
Michigan MEDICAID 4348724 BLUE CROSS BLUE SHIELD #
Michigan Other P00019530 BLUE CROSS BLUE SHIELD #

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