Provider Demographics
NPI:1629054242
Name:HAGUE, JOHN M (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:HAGUE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:8902 N MERIDIAN ST
Mailing Address - Street 2:STE 210
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5382
Mailing Address - Country:US
Mailing Address - Phone:317-844-6444
Mailing Address - Fax:317-848-6605
Practice Address - Street 1:8902 N MERIDIAN ST
Practice Address - Street 2:STE 210
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5382
Practice Address - Country:US
Practice Address - Phone:317-844-6444
Practice Address - Fax:317-848-6605
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2009-03-24
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Provider Licenses
StateLicense IDTaxonomies
IN01022757207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
INC24289Medicare UPIN
IN067460AMedicare ID - Type Unspecified