Healthcare Provider Details

I. General information

NPI: 1396910956
Provider Name (Legal Business Name): RICHARD HAINER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1349 S ROCHESTER RD SUITE 205
ROCHESTER HILLS MI
48307-3150
US

IV. Provider business mailing address

1349 S ROCHESTER RD SUITE 205
ROCHESTER HILLS MI
48307-3150
US

V. Phone/Fax

Practice location:
  • Phone: 248-601-4240
  • Fax: 248-601-4234
Mailing address:
  • Phone: 248-601-4240
  • Fax: 248-601-4234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number4301056609
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number4301056609
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number4301056609
License Number StateMI
# 4
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number4301056609
License Number StateMI

VIII. Authorized Official

Name: RICHARD HAINER
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 248-601-4240