Healthcare Provider Details

I. General information

NPI: 1750367058
Provider Name (Legal Business Name): EDWARD ARON HAASS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2005
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22731 NEWMAN ST STE 100B
DEARBORN MI
48124-2023
US

IV. Provider business mailing address

29900 LORRAINE AVE SUITE 400
WARREN MI
48093-5266
US

V. Phone/Fax

Practice location:
  • Phone: 313-791-0616
  • Fax:
Mailing address:
  • Phone: 586-582-0864
  • Fax: 586-582-0964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number5101014611
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: