Harris, Matthew Wayne
Harris, Matthew Wayne is an individual health care provider with primary practice located at 5900 Waldon Rd Ste D , Clarkston MI 48346-4806. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Harris, Matthew Wayne can be contacted via phone (810) 424-2411.Contact Information
Primary practice address
5900 Waldon Rd Ste D
Clarkston MI 48346-4806
Phone: (810) 424-2411
Fax: (810) 249-4420
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 4301051360 | Michigan |
Profile Details
| NPI number | 1154314029 |
|---|---|
| LBN Legal business name | Harris, Matthew Wayne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 25th, 2005 |
| Last updated | Oct 8th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154314029 | NPPES |
| West Virginia | MEDICAID | 1801405000 | |
| West Virginia | MEDICAID | 64699630 | |
| West Virginia | MEDICAID | 0868575 |
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