Provider Demographics
NPI:1134001282
Name:GARRIS, MICHAELS
Entity type:Individual
Prefix:
First Name:MICHAELS
Middle Name:
Last Name:GARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 GREENVILLE BLVD SE STE 400-372
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5135
Mailing Address - Country:US
Mailing Address - Phone:252-567-2538
Mailing Address - Fax:
Practice Address - Street 1:740 GREENVILLE BLVD SE STE 400-372
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5135
Practice Address - Country:US
Practice Address - Phone:252-567-2538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy