Provider Demographics
NPI:1932177995
Name:HARRIS, CHRISTOPHER LEE (IDC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:LEE
Last Name:HARRIS
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS ALASKA
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AA
Mailing Address - Zip Code:34090-2111
Mailing Address - Country:US
Mailing Address - Phone:912-573-8224
Mailing Address - Fax:912-573-4534
Practice Address - Street 1:USS ALASKA (SSBN 732)(BLUE)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AA
Practice Address - Zip Code:34090-2111
Practice Address - Country:US
Practice Address - Phone:912-573-8224
Practice Address - Fax:912-573-4534
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-08
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman