Healthcare Provider Details

I. General information

NPI: 1285719807
Provider Name (Legal Business Name): STEVEN JOSEPH HAUG M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1133 COLLEGE AVE STE G-210
MANHATTAN KS
66502-2770
US

IV. Provider business mailing address

1133 COLLEGE AVE STE G-210
MANHATTAN KS
66502-2770
US

V. Phone/Fax

Practice location:
  • Phone: 785-537-9030
  • Fax: 785-537-3334
Mailing address:
  • Phone: 785-537-9030
  • Fax: 785-537-3334

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-22194
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number04 22194
License Number StateKS

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier25067HA
Identifier TypeOTHER
Identifier StateKS
Identifier IssuerBLUE SHIELD
# 2
Identifier100207800A
Identifier TypeMEDICAID
Identifier StateKS
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: