Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 46143 | WI |
Y | 2080P0210X | Pediatric Nephrologist | 46143 | WI |
NPI | 1205936457 |
---|---|
Provider Name | Robert M Haws |
First Address | Marshfield, WI 54449-5777 |
Second Address | Marshfield, WI 54449-5777 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 17/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34454800 | (05) | WI |
E42194 | (02) |