Provider Demographics
NPI:1437995966
Name:MICHAEL, HAROLD J (PRSS)
Entity type:Individual
Prefix:
First Name:HAROLD
Middle Name:J
Last Name:MICHAEL
Suffix:
Gender:M
Credentials:PRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 N SIERRA ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89503-3722
Mailing Address - Country:US
Mailing Address - Phone:775-329-9830
Mailing Address - Fax:
Practice Address - Street 1:1015 N SIERRA ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89503-3722
Practice Address - Country:US
Practice Address - Phone:775-329-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPRSS-5105175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist