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Contact Information

CARSON R HARRIS, MD
8040 OLD CEDAR AVE S STE 100
BLOOMINGTON, MN55425-1205
 Phone: 651-254-3456
 Fax: 651-254-5216
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

2083A0300X 84 Physician/Preventive Medicine
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for CARSON R HARRIS · (Male)

NPI # 1598730152
Status Active
Credentials MD
Entity Individual
Enumeration date 02/17/2006
Last updated 06/11/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 31091
  • MN Medicaid 53585100
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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