Provider Demographics
NPI:1851452379
Name:HALLER & HUG, PC
Entity Type:Organization
Organization Name:HALLER & HUG, PC
Other - Org Name:HALLER HUG & POPP PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-477-5608
Mailing Address - Street 1:27555 FARMINGTON RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-3376
Mailing Address - Country:US
Mailing Address - Phone:248-477-5608
Mailing Address - Fax:248-427-0010
Practice Address - Street 1:27555 FARMINGTON RD
Practice Address - Street 2:SUITE 120
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3376
Practice Address - Country:US
Practice Address - Phone:248-477-5608
Practice Address - Fax:248-427-0010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MICG8853OtherRAILROAD MEDICARE
MI0F31194OtherBLUE CROSS
0M113400Medicare ID - Type Unspecified