1811967334 NPI number — DR. JOHN FREDERICK HARB MD

Table of content: DR. JOHN FREDERICK HARB MD (NPI 1811967334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811967334 NPI number — DR. JOHN FREDERICK HARB MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARB
Provider First Name:
JOHN
Provider Middle Name:
FREDERICK
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1811967334
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/14/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
39000 7 MILE RD STE 2500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LIVONIA
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48152-1006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-462-5858
Provider Business Mailing Address Fax Number:
734-462-5860

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
39000 7 MILE RD STE 2500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48152-1006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-462-5858
Provider Business Practice Location Address Fax Number:
734-462-5860
Provider Enumeration Date:
01/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  JH061957 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 126793 . This is a "CARE CHOICES ID NUMBER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 340H249310 . This is a "BLUE CROSS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 383468117 . This is a "TAX ID" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 10/4105806 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 17069 . This is a "M-CARE ID NUMBER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: JH061957 . This is a "LICENSE NUMBER" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 3408276971 . This is a "BLUE CARE NETWORK" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 5211703 . This is a "AETNA" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 126793 . This is a "PREFERRED CHOICES ID NUMB" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".
  • Identifier: 340016693 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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