Provider Demographics
NPI:1043259773
Name:HAUGLAND, DAVID BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:HAUGLAND
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 1:3000 HUNDERTMARK RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1150
Mailing Address - Country:US
Mailing Address - Phone:952-556-0120
Mailing Address - Fax:952-556-0121
Practice Address - Street 1:424 W HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-1723
Practice Address - Country:US
Practice Address - Phone:952-442-4461
Practice Address - Fax:952-442-1547
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN38826207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
39-40266OtherMEDICA EMERG
MN532214600Medicaid
111236OtherUCARE
51Q98HAOtherBCBS
HP22813OtherHEALTH PARTNERS
1014198OtherPREFERRED ONE
66-08243OtherMEDICA UC
51Q98HAOtherBCBS
080007084Medicare ID - Type Unspecified
080154812Medicare PIN
080007084Medicare PIN
111236OtherUCARE
CS6766Medicare PIN