Provider Demographics
NPI:1699723981
Name:HAAS, ANDREW J JR (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:J
Last Name:HAAS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 FIFTH STREET NE
Mailing Address - Street 2:
Mailing Address - City:BABERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203
Mailing Address - Country:US
Mailing Address - Phone:330-753-7876
Mailing Address - Fax:330-848-3285
Practice Address - Street 1:155 FIFTH STREET NE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203
Practice Address - Country:US
Practice Address - Phone:330-753-7876
Practice Address - Fax:330-848-3285
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2011-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35 047196207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0493907Medicaid
OH0511992Medicare PIN
OHA15098Medicare UPIN