Healthcare Provider Details

I. General information

NPI: 1093786436
Provider Name (Legal Business Name): CHRISTOPHER HAAS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2006
Last Update Date: 01/25/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12502 WILLOWBROOK RD SUITE 330
CUMBERLAND MD
21502-6491
US

IV. Provider business mailing address

PO BOX 1671
CUMBERLAND MD
21501-1671
US

V. Phone/Fax

Practice location:
  • Phone: 240-964-8740
  • Fax:
Mailing address:
  • Phone: 240-964-8342
  • Fax: 240-964-8337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberH69925
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberH69925
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberH69925
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: