Physician Compare National (NPI:1548740772)

HEALTHCARE PROVIDER: TREY MICHEL HAUGEN OD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1548740772
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991031692
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190801000742
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HAUGEN
	Individual professional last name
Provider First Name	TREY
	Individual professional first name
Provider Middle Name	MICHEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CHESAPEAKE EYE CARE AND LASER CENTER
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2769460971
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	43
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8601 LA SALLE RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 108
	Group Practice or individual's line 2 address
City	TOWSON
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	212862005
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4108216400
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y