Provider Demographics
NPI:1487817003
Name:HARMON DOCTORS' CLINIC
Entity Type:Organization
Organization Name:HARMON DOCTORS' CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:MACRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:671-637-1777
Mailing Address - Street 1:2214 ARMY DR
Mailing Address - Street 2:
Mailing Address - City:DEDEDO
Mailing Address - State:GU
Mailing Address - Zip Code:96929-6520
Mailing Address - Country:US
Mailing Address - Phone:671-637-1777
Mailing Address - Fax:671-637-4385
Practice Address - Street 1:2214 ARMY DR
Practice Address - Street 2:
Practice Address - City:DEDEDO
Practice Address - State:GU
Practice Address - Zip Code:96929-6520
Practice Address - Country:US
Practice Address - Phone:671-637-1777
Practice Address - Fax:671-637-4385
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-03
Last Update Date:2008-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM 910261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service