Provider Demographics
NPI:1144394503
Name:HARP, LEWIS W (DC)
Entity Type:Individual
Prefix:
First Name:LEWIS
Middle Name:W
Last Name:HARP
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E MAPLE RD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6408
Mailing Address - Country:US
Mailing Address - Phone:248-540-8888
Mailing Address - Fax:248-540-8889
Practice Address - Street 1:950 E MAPLE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6408
Practice Address - Country:US
Practice Address - Phone:248-645-6070
Practice Address - Fax:248-645-2949
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2012-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301002926111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0F35243Medicare ID - Type UnspecifiedPROVIDER NUMBER