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General NPI Number Information
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NPI Number | 1770760175
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Entity Type | Organization
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Legal Business Name | GREGORY HAINES MD LLC
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Dates
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Enumeration Date | 01/28/2008
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Last Update Date | 02/18/2008
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Provider Practice Location Address
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Address Line | 8750 TELEGRAPH RD SUITE 108
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City | TAYLOR
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State | MI
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Zip | 48180-2397
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Country | US
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Telephone | 313-299-8900
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Fax | 313-299-8600
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Provider Business Mailing Address
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Address Line | 8750 TELEGRAPH RD SUITE 108
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City | TAYLOR
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State | MI
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Zip | 48180-2397
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Country | US
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Telephone | 313-299-8900
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Fax | 313-299-8600
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY HAINES
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Credential | MD
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Telephone | 313-299-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State | MI
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