Provider Demographics
NPI:1205043726
Name:HAUGHEY, MICHAEL JAMES
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:JAMES
Last Name:HAUGHEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3337 POWELL LOOP APT C
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-4222
Mailing Address - Country:US
Mailing Address - Phone:808-473-2899
Mailing Address - Fax:808-473-3109
Practice Address - Street 1:822 CLARK ST
Practice Address - Street 2:SUITE 400
Practice Address - City:PEARL HARBOR
Practice Address - State:HI
Practice Address - Zip Code:96860-4652
Practice Address - Country:US
Practice Address - Phone:808-473-2899
Practice Address - Fax:808-473-3109
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman