Provider Demographics
NPI:1982607347
Name:HARRIS, MALATI K (MD)
Entity type:Individual
Prefix:
First Name:MALATI
Middle Name:K
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:901 KENTUCKY ST STE 108
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2853
Mailing Address - Country:US
Mailing Address - Phone:785-453-8967
Mailing Address - Fax:866-483-4087
Practice Address - Street 1:901 KENTUCKY ST STE 108
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2853
Practice Address - Country:US
Practice Address - Phone:785-453-8967
Practice Address - Fax:866-483-4087
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0427782207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200266060AMedicaid
KS103852Medicare PIN
KSI13163Medicare UPIN