Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301056609 | MI |
N | 208600000X | Surgeon | 4301056609 | MI |
N | 2082S0105X | Plastic Hand Surgeon | 4301056609 | MI |
N | 2086S0105X | Surgery of the Hand | 4301056609 | MI |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 4301056609 | MI |
NPI | 1821017963 |
---|---|
Provider Name | Richard Hainer |
First Address | Rochester Hills, MI 48307-2061 |
Second Address | Rochester Hills, MI 48307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1396910956 | CORPORATE NPI (01) | MI |
383539190 | TAX ID (01) | MI |
4301056609 | STATE LICENSE (01) | MI |
G77324 | UPIN (01) | MI |