Provider Demographics
NPI:1639132152
Name:HAFT, HOWARD MARK (MD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:MARK
Last Name:HAFT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3070 CRAIN HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20601-2830
Mailing Address - Country:US
Mailing Address - Phone:301-645-3556
Mailing Address - Fax:301-645-3932
Practice Address - Street 1:3070 CRAIN HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-2830
Practice Address - Country:US
Practice Address - Phone:301-645-3556
Practice Address - Fax:301-645-3932
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2014-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD27348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD330031500Medicaid
MD454L276CMedicare PIN
DC00353M92Medicare PIN
MD140184Y3NMedicare PIN
MDA89666Medicare UPIN
MD110138063Medicare PIN