Angela L. Harris, M.D., P.C.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301058258 Issued in MI

Legal business name

ANGELA L. HARRIS, M.D., P.C.

Practice address

2950 W Outer Dr
Detroit, MI 48221-1750

Phone

(313) 586-7400

Fax

(313) 221-9124

NPI assigned

Jun 26, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Angela Lenell Harris, M.D.

Title

Owner

Phone

(313) 586-7400

Specialties & licenses 1

Addresses

Other identifiers 5

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1119744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356998400000",
    "number": "1467458257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21893",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482210893",
            "telephone_number": "313-586-7400",
            "fax_number": "313-221-9124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211750",
            "telephone_number": "313-586-7400",
            "fax_number": "313-221-9124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA L. HARRIS, M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-26",
        "last_updated": "2013-01-01",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LENELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-586-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301058258",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "080H237420",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH PLAN",
            "identifier": "1363702",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5717471",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN/ GREAT-WEST HEALTHCARE",
            "identifier": "211296",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3395292",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Angela'S House Residential Care, LLC
• Jerky Guevara Angeles, BSN RN
• Angelhands Homecare
• Angelic Assistance Agency LLC
• Angelic Care Services

• Family Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.