Provider Demographics
NPI:1154489599
Name:HAUG, CHRISTIAN MELVIN (DC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MELVIN
Last Name:HAUG
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 13TH AVE SW
Mailing Address - Street 2:STE #3
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103
Mailing Address - Country:US
Mailing Address - Phone:701-234-0057
Mailing Address - Fax:701-234-0422
Practice Address - Street 1:3301 13TH AVE SW
Practice Address - Street 2:STE #3
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103
Practice Address - Country:US
Practice Address - Phone:701-234-0057
Practice Address - Fax:701-234-0422
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND010594Medicaid
ND19397OtherBLUE CROSS & BLUE SHIELD
ND010594Medicaid