MEDICARE: RICHARD EDWIN HAIGLER 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	207X00000X	Orthopaedic Surgery Physician	BP10037398	TX
2	207X00000X	Orthopaedic Surgery Physician	2016-00336	NC

General Provider Information

NPI Number	:	1578889200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD EDWIN HAIGLER MD

Provider Business Mailing Address
First Line	:	PO BOX 60447
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-0447
Country	:	US
Telephone Number	:	336-893-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	7138 VILLAGE MEDICAL CIR
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012-8004
Country	:	US
Telephone Number	:	336-893-2100
Fax Number	:

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

Provider Enumeration Date	:	04/20/2010
Last Update Date	:	10/25/2020

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