Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301005228 | MI |
N | 111NR0200X | Radiology | 27309 | MI |
N | 213ER0200X | Radiology | 27309 | MI |
NPI | 1609091180 |
---|---|
Provider Name | Matthew Eric Haglund |
First Address | Carson City, MI 48811 |
Second Address | Carson City, MI 48811 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2007 |
Last Update Date | 13/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200000005749 | PHYSICIANS HEALTH PLAN (01) | MI |
95OE910310 | BCBS OF MICHIGAN (01) | MI |
T96826 | (02) | MI |