Provider Demographics
NPI:1033183637
Name:HAGGINS-DABNEY, JANEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JANEAN
Middle Name:
Last Name:HAGGINS-DABNEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANEAN
Other - Middle Name:
Other - Last Name:HAGGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1014 SIXTH ST
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-2381
Mailing Address - Country:US
Mailing Address - Phone:231-922-9270
Mailing Address - Fax:231-922-9271
Practice Address - Street 1:416 CONNABLE AVE
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2212
Practice Address - Country:US
Practice Address - Phone:231-922-9270
Practice Address - Fax:231-922-9271
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G14203Medicare UPIN