Healthcare Provider Details

I. General information

NPI: 1124018213
Provider Name (Legal Business Name): MICHAEL S HAUPERT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7001 ORCHARD LAKE RD SUITE 320C
WEST BLOOMFIELD MI
48322-3604
US

IV. Provider business mailing address

7001 ORCHARD LAKE RD SUITE 320C
WEST BLOOMFIELD MI
48322-3604
US

V. Phone/Fax

Practice location:
  • Phone: 248-571-3600
  • Fax: 248-973-8560
Mailing address:
  • Phone: 248-571-3600
  • Fax: 248-973-8560

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number5101010352
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: