Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 7446 | IA |
N | 213EG0000X | General Practice | 7446 | IA |
N | 1223P0700X | Prosthodontist | 7446 | IA |
NPI | 1003943143 |
---|---|
Provider Name | Dr. Chris R Haganman |
First Address | Cedar Rapids, IA 52403-4300 |
Second Address | Cedar Rapids, IA 52403-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0280362 | (05) | IA |