Provider Demographics
NPI:1982820742
Name:HARRIS, HARRY MILLS (MD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:MILLS
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 1:2 CROSS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:MD
Mailing Address - Zip Code:21131-1000
Mailing Address - Country:US
Mailing Address - Phone:410-771-4168
Mailing Address - Fax:
Practice Address - Street 1:300 ARMORY PL # S3-C
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4603
Practice Address - Country:US
Practice Address - Phone:410-225-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2020-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD26880174400000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD35216801OtherCAREFIRST
MD460271400Medicaid
MDW2770001OtherCAREFIRST FEDERAL
MD460271400Medicaid
MDD74616Medicare UPIN