Provider Demographics
NPI:1841257516
Name:HAAHS, MICHAEL M (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:M
Last Name:HAAHS
Suffix:
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 1:134 MEDICAL PARK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8526
Mailing Address - Country:US
Mailing Address - Phone:704-799-8182
Mailing Address - Fax:704-799-8973
Practice Address - Street 1:134 MEDICAL PARK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8526
Practice Address - Country:US
Practice Address - Phone:704-799-8182
Practice Address - Fax:704-799-8973
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9400515173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937987Medicaid
NCF77299Medicare UPIN
NC2196811CMedicare ID - Type Unspecified