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1396781357

NPI Code Detail

MEDICARE: DR. BRIAN W HAAG MD

MEDICARE: DR. BRIAN W HAAG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	01028599A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020010156	OTHER		MEDICARE RAIL ROAD
3	020039695	OTHER	IN	MEDICARE RAIL ROAD (IU HEALTH)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396781357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN W HAAG MD

Provider Business Mailing Address
First Line	:	6620 PARKDALE PL
Second Line	:	SUITE N
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5620
Country	:	US
Telephone Number	:	317-244-7160
Fax Number	:	317-244-7166

Provider Business Practice Location Address
First Line	:	6620 PARKDALE PL
Second Line	:	SUITE N
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-5620
Country	:	US
Telephone Number	:	317-244-7160
Fax Number	:	317-244-7166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	05/04/2015

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Directions to “ DR. BRIAN W HAAG MD” Practice Location

Language	Start Address	Practice Location

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