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Contact Information

HOLLY L HAKE HARRIS, MD
211 N EDDY ST
SOUTH BEND, IN46617-2808
 Phone: 574-237-9231
 Fax: 574-237-9208
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dermatology

207N00000X 07 Physician/Dermatology
Indicates primary specialty

NPI Profile & details for HOLLY L HAKE HARRIS · (Female)

NPI Number 1538159207
Status Active
Credentials MD
Entity Individual
Enumeration date 10/25/2005
Last updated 02/04/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • IN License # 01035334A
  • IN Medicaid 100090170
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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