Provider Demographics
NPI:1760589642
Name:HAAS, INGRID ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:INGRID
Middle Name:ELIZABETH
Last Name:HAAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10617 N HAYDEN RD
Mailing Address - Street 2:SUITE B-102
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5578
Mailing Address - Country:US
Mailing Address - Phone:480-483-9011
Mailing Address - Fax:480-483-2803
Practice Address - Street 1:10617 N HAYDEN RD
Practice Address - Street 2:SUITE B-102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5578
Practice Address - Country:US
Practice Address - Phone:480-483-9011
Practice Address - Fax:480-483-2803
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13329174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ4123900OtherCIGNA
AZ0700328OtherUNITED HEALTHCARE
AZAZ0031990OtherBLUECROSS
AZ0700328OtherUNITED HEALTHCARE
AZ4123900OtherCIGNA