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General NPI Number Information
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NPI Number | 1154405009
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Entity Type | Individual
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Provider Name | STANLEY HAEGERT MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 09/16/2019
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Provider Practice Location Address
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Address Line | 1310 WISCONSIN ST SUITE 103
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2472
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Country | US
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Telephone | 616-846-2640
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Fax | 616-846-3110
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Provider Business Mailing Address
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Address Line | 1310 WISCONSIN ST SUITE 101
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City | GRAND HAVEN
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State | MI
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Zip | 49417-2472
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Country | US
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Telephone | 616-847-5604
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Fax | 616-847-5608
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 64514
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11742C
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License Number State | WY
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60893797
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G158510
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036147324
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License Number State | IL
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 18348
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License Number State | NV
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD-46030
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License Number State | IA
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11380
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License Number State | SD
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301407097
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License Number State | MI
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Taxonomy #10
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CDRH.0061038
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License Number State | CO
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Taxonomy #11
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 57243
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License Number State | AZ
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Taxonomy #12
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MC-0098
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License Number State | ID
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