Provider Demographics
NPI:1407877707
Name:HARRIS, CRAIG KURT (MD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:KURT
Last Name:HARRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32800 LORAIN RD STE 2300
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-3430
Mailing Address - Country:US
Mailing Address - Phone:440-406-5500
Mailing Address - Fax:440-406-5501
Practice Address - Street 1:32800 LORAIN RD STE 2300
Practice Address - Street 2:
Practice Address - City:NORTH RIDGEVILLE
Practice Address - State:OH
Practice Address - Zip Code:44039-3430
Practice Address - Country:US
Practice Address - Phone:440-406-5500
Practice Address - Fax:440-406-5501
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.039753207RG0100X
OH35039753207RG0100X
OH35039759207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0450766Medicaid
OH110084384OtherRAILROAD MEDICARE
OH0450766Medicaid
OHC02048Medicare UPIN
OHHA0493172Medicare Oscar/Certification