Provider Demographics
NPI:1205827466
Name:HAUGE, MARK D (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:D
Last Name:HAUGE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2550 UNIVERSITY AVE W STE 110N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-2001
Mailing Address - Country:US
Mailing Address - Phone:651-602-5309
Mailing Address - Fax:651-222-6786
Practice Address - Street 1:601 W CHANDLER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MN
Practice Address - Zip Code:55307-2127
Practice Address - Country:US
Practice Address - Phone:507-964-2271
Practice Address - Fax:507-964-5898
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2018-03-17
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Provider Licenses
StateLicense IDTaxonomies
MN23544207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
110902OtherU CARE
3600191OtherMEDICA HEALTH PLANS
508R1HAOtherBLUE CROSS BLUE SHIELD
600901OtherARAZ GROUP AMERICAS PPO
110105132OtherRR MEDICARE
6D067HAOtherBLUE CROSS BLUE SHIELD
HP13485OtherHEALTH PARTNERS
1000212OtherPREFERRED ONE
2114005OtherFIRST HEALTH PLAN
878098600OtherMEDICAL ASSISTANCE
878098600OtherMEDICAL ASSISTANCE
D81482Medicare UPIN