Provider Demographics
NPI:1609112713
Name:HAUTEKEET, MICHAEL MARKUS (PHARM D, RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:MARKUS
Last Name:HAUTEKEET
Suffix:
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 N CURRY ST
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3975
Mailing Address - Country:US
Mailing Address - Phone:775-841-1400
Mailing Address - Fax:775-841-1499
Practice Address - Street 1:1007 N CURRY ST
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3975
Practice Address - Country:US
Practice Address - Phone:775-841-1400
Practice Address - Fax:775-841-1499
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist