Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 48830 | WI |
NPI | 1023063021 |
---|---|
Provider Name | Alice S Haupt |
First Address | Platteville, WI 53818-9800 |
Second Address | Platteville, WI 53818-9800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 22/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34825900 | (05) | WI |
G81111 | (02) |