Provider Demographics
NPI:1093787335
Name:HARRIS, CATHLEEN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHLEEN
Middle Name:MARIE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6950 E CHAUNCEY LN
Mailing Address - Street 2:SUITE 150
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-5178
Mailing Address - Country:US
Mailing Address - Phone:480-970-7664
Mailing Address - Fax:480-970-1907
Practice Address - Street 1:6950 E CHAUNCEY LN
Practice Address - Street 2:SUITE 150
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-5178
Practice Address - Country:US
Practice Address - Phone:480-970-7664
Practice Address - Fax:480-970-1907
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ28098207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F84639Medicare UPIN