Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301067869 | MI |
N | 208600000X | Surgeon | 4301067869 | MI |
Y | 2082S0105X | Plastic Hand Surgeon | 4301067869 | MI |
NPI | 1396843017 |
---|---|
Provider Name | Steven Carl Haase |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48105-9484 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 23/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4628290 | (05) | MI |
H82772 | (02) | MI |