Provider Demographics
NPI:1376530717
Name:HAUS, MARY MARGARET (MD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MARGARET
Last Name:HAUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 EOFF ST
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-3823
Mailing Address - Country:US
Mailing Address - Phone:304-234-8663
Mailing Address - Fax:304-234-8960
Practice Address - Street 1:2000 EOFF ST
Practice Address - Street 2:SUITE 603
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-3823
Practice Address - Country:US
Practice Address - Phone:304-234-3405
Practice Address - Fax:304-234-3406
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039107L207X00000X
WV01625207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2694713Medicaid
WV3810006065Medicaid
WVP00345755OtherRAILROAD MEDICARE
OH2694713Medicaid
WV3810006065Medicaid
C34584Medicare UPIN