Provider Demographics
NPI:1639132152
Name:HAFT, HOWARD MARK (MD)
Entity type:Individual
Prefix:
First Name:HOWARD
Middle Name:MARK
Last Name:HAFT
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:382 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1329
Mailing Address - Country:US
Mailing Address - Phone:667-868-4047
Mailing Address - Fax:667-868-4044
Practice Address - Street 1:382 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1329
Practice Address - Country:US
Practice Address - Phone:667-868-4047
Practice Address - Fax:667-868-4044
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD27348207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
W25592130OtherSTATE BUSINESS IDN
MD330031500Medicaid
DC00353M92Medicare PIN
MD140184Y3NMedicare PIN
MDA89666Medicare UPIN
MD110138063Medicare PIN