Michael L. Harris MD, LTD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

17469 Issued in WV

Legal business name

MICHAEL L. HARRIS MD, LTD

Practice address

4501 Maccorkle Ave SW
Suite 500
South Charleston, WV 25309-1444

Phone

(304) 766-6266

Fax

(304) 766-7825

NPI assigned

Jun 22, 2007

Organization subpart

No

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

Authorized official

Name

Michael Lindon Harris, MD

Title

Owner

Phone

(304) 766-6266

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Michael L. Harris, M.D., LTD.

  • Ophthalmology Physician
  • South Charleston, WV
  • NPI 1730260399

  O20041227000458

  Same enrollment

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649476169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 MACCORKLE AVE SW",
            "address_2": "SUITE 500",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091444",
            "telephone_number": "304-766-6266",
            "fax_number": "304-766-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 MACCORKLE AVE SW",
            "address_2": "SUITE 500",
            "city": "SOUTH CHARLESTON",
            "state": "WV",
            "postal_code": "253091444",
            "telephone_number": "304-766-6266",
            "fax_number": "304-766-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL L. HARRIS MD, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LINDON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "304-766-6266",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "WV",
            "license": "17469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0095821001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michael L. Harris, M.D., LTD.
• Michael Sitler, MD, Inc.
• Roberta Mickey
• Cheryl Midkiff
• Cynthia Milam

• Eyewear Supplier in South Charleston, WV
• Providers in South Charleston, WV by specialty
• Eyewear Supplier in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.