Provider Demographics
NPI:1558893149
Name:HARRIS, AISHA MYSHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:AISHA
Middle Name:MYSHELLE
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 N SAGINAW ST STE 401A
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-2013
Mailing Address - Country:US
Mailing Address - Phone:810-214-0075
Mailing Address - Fax:
Practice Address - Street 1:432 N SAGINAW ST STE 401A
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-2013
Practice Address - Country:US
Practice Address - Phone:810-214-0075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-01
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301501444207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine