Provider Demographics
NPI:1952351504
Name:HAINER, BOZENA BEATRICE (MD)
Entity Type:Individual
Prefix:DR
First Name:BOZENA
Middle Name:BEATRICE
Last Name:HAINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BOZENA
Other - Middle Name:B
Other - Last Name:HAINER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1701 SOUTH BOULEVARD, EAST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307
Mailing Address - Country:US
Mailing Address - Phone:248-997-5805
Mailing Address - Fax:248-997-5811
Practice Address - Street 1:1701 SOUTH BOULEVARD, EAST
Practice Address - Street 2:SUITE 200
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307
Practice Address - Country:US
Practice Address - Phone:248-997-5805
Practice Address - Fax:248-997-5811
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIBH039081207V00000X
MI4301039081207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI20V00000XOtherTYPE 16: OB AND GYN
MI1606354441OtherBCBSM
MI4883293Medicaid
MI1606354441OtherBCBSM
MIA73931Medicare UPIN