Doctor Name: | MICHAEL HAAS |
NPI Number: | 1609017318 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301027293 |
Business Practice Address: | 55 Fontana Ln Grosse Pointe Shores, MI - 482361504 |
Business Phone Number: | 3138862449 |
Business Fax Number: | |
Mailing Address: | 55 Fontana Ln, GROSSE POINTE SHORES |
State: | MI |
Postal Code: | 482361504 |
Phone Number: | 3138862449 |
Fax Number: | |
NPI Enumeration Date: | 03/11/2009 |
NPI Last Update Date: | 03/11/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301027293 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |