Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 35-05-5161 | OH |
NPI | 1023015674 |
---|---|
Provider Name | Dr. Mitchell Haut |
First Address | Canton, OH 44708-2609 |
Second Address | Canton, OH 44708-2609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 25/11/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0762474 | (05) | OH |
E61384 | (02) | OH |