Provider Demographics
NPI:1417119009
Name:HASELKORN, M. LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:M. LEE
Middle Name:
Last Name:HASELKORN
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 1:2000 OXFORD DR STE 303
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1841
Mailing Address - Country:US
Mailing Address - Phone:412-942-7875
Mailing Address - Fax:
Practice Address - Street 1:2000 OXFORD DR STE 303
Practice Address - Street 2:
Practice Address - City:BETHEL PARK
Practice Address - State:PA
Practice Address - Zip Code:15102-1841
Practice Address - Country:US
Practice Address - Phone:412-942-7875
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258192207L00000X
PAMD449206207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology