Basic Information
Provider Information
NPI: 1003007345
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARLOW
FirstName: MICHAEL
MiddleName: CHARLES
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HARLOW
OtherFirstName: MICHAEL
OtherMiddleName: CHARLES
OtherNamePrefix: MR.
OtherNameSuffix:  
OtherCredential: J.D.
OtherLastNameType: 2
Mailing Information
Address1: 900 S 8TH ST STE 110
Address2: HENNEPIN COUNTY MEDICAL CENTER
City: MINNEAPOLIS
State: MN
PostalCode: 554041292
CountryCode: US
TelephoneNumber: 6123472218
FaxNumber: 6123731859
Practice Location
Address1: 900 S 8TH ST STE 110
Address2: HENNEPIN COUNTY MEDICAL CENTER
City: MINNEAPOLIS
State: MN
PostalCode: 554041292
CountryCode: US
TelephoneNumber: 6123472218
FaxNumber: 6123731859
Other Information
ProviderEnumerationDate: 08/01/2007
LastUpdateDate: 11/08/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800X49531MNY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800XRL0467SDN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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