Provider Demographics
NPI:1588633440
Name:HAAS, MICHAEL SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:HAAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-4319
Mailing Address - Country:US
Mailing Address - Phone:540-389-7466
Mailing Address - Fax:540-389-7969
Practice Address - Street 1:524 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-4319
Practice Address - Country:US
Practice Address - Phone:540-389-7466
Practice Address - Fax:540-389-7969
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA061280000-00OtherQUALCHOICE
VAP00188499OtherMEDICARE-RAILROAD
VA171892OtherANTHEM
VA20-1415011OtherMAMSI
VA20-1415011OtherCIGNA
VA000300101OtherPRACTITIONER
VA20-1415011OtherAETNA
VA20-1415011OtherCIGNA