Provider Demographics
NPI:1407345648
Name:HARRIS, CLAY CHRISTOPHER
Entity Type:Individual
Prefix:
First Name:CLAY
Middle Name:CHRISTOPHER
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 FALLSTAFF RD APT T4
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3224
Mailing Address - Country:US
Mailing Address - Phone:301-980-9568
Mailing Address - Fax:
Practice Address - Street 1:2907 FALLSTAFF RD APT T4
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3224
Practice Address - Country:US
Practice Address - Phone:301-980-9568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant