Provider Demographics
NPI:1922100023
Name:HAUER, KIRSTEN ANDREA (MD)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:ANDREA
Last Name:HAUER
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 1:3301 LANCASTER PIKE
Mailing Address - Street 2:SUITE 9
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805
Mailing Address - Country:US
Mailing Address - Phone:302-661-2303
Mailing Address - Fax:302-661-2324
Practice Address - Street 1:3301 LANCASTER PIKE
Practice Address - Street 2:SUITE 9
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805
Practice Address - Country:US
Practice Address - Phone:302-661-2303
Practice Address - Fax:302-661-2324
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000398601Medicaid
490708Medicare ID - Type Unspecified
DE0000398601Medicaid