Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 35067825H | OH |
NPI | 1073502720 |
---|---|
Provider Name | Christopher A. Haas |
First Address | Lorain, OH 44053-1652 |
Second Address | Lorain, OH 44053-1652 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2005 |
Last Update Date | 20/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3025372 | (05) | OH |
H02865 | (02) | OH |