Provider Demographics
NPI:1699909408
Name:DAVID HARRIS, M.D. P.C.
Entity type:Organization
Organization Name:DAVID HARRIS, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:303-344-1162
Mailing Address - Street 1:830 POTOMAC CIR UNIT 275
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-6797
Mailing Address - Country:US
Mailing Address - Phone:303-805-7686
Mailing Address - Fax:303-805-7732
Practice Address - Street 1:830 POTOMAC CIR UNIT 275
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-6797
Practice Address - Country:US
Practice Address - Phone:303-805-7686
Practice Address - Fax:303-805-7732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17216207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO04017422Medicaid