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General NPI Number Information
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NPI Number | 1902212145
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Entity Type | Organization
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Legal Business Name | NELSON S HAAS MD PC
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 1734 CRAWFORD FARM RD
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City | NEWPORT
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State | VT
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Zip | 05855-4509
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Country | US
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Telephone | 802-334-9300
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Fax | 802-334-9299
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Provider Business Mailing Address
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Address Line | 1734 CRAWFORD FARM RD
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City | NEWPORT
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State | VT
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Zip | 05855-4509
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Country | US
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Telephone | 802-334-9300
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Fax | 802-334-9299
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. NELSON STUART HAAS
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Credential | M.D
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Telephone | 802-334-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number | 042-0010304
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License Number State | VT
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