Provider Demographics
NPI:1649262692
Name:HAAG, MICHAEL LEE (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LEE
Last Name:HAAG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11041 HAUSER ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3708
Mailing Address - Country:US
Mailing Address - Phone:913-888-3376
Mailing Address - Fax:913-888-3386
Practice Address - Street 1:11041 HAUSER ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66210-3708
Practice Address - Country:US
Practice Address - Phone:913-888-3376
Practice Address - Fax:913-888-3386
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2012-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0425210207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSF85815Medicare UPIN
KSQ965628Medicare PIN