Provider Demographics
NPI:1659397339
Name:MACRIS, HARIS C (MD)
Entity Type:Individual
Prefix:DR
First Name:HARIS
Middle Name:C
Last Name:MACRIS
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 1:33155 ANNAPOLIS AVE
Mailing Address - Street 2:OAKWOOD FAMILY MEDICINE RESIDENCY PROGRAM
Mailing Address - City:WAYNE
Mailing Address - State:MI
Mailing Address - Zip Code:48184
Mailing Address - Country:US
Mailing Address - Phone:734-467-2483
Mailing Address - Fax:
Practice Address - Street 1:18723 AUDETTE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4274
Practice Address - Country:US
Practice Address - Phone:313-359-2775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine