MEDICARE: DOUG HAAR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171WH0202X	Home Modifications Contractor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043624729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUG HAAR

Provider Business Mailing Address
First Line	:	6483 HOLLY HILL LN
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6448
Country	:	US
Telephone Number	:	513-295-1482
Fax Number	:

Provider Business Practice Location Address
First Line	:	6483 HOLLY HILL LN
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-6448
Country	:	US
Telephone Number	:	513-295-1482
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/20/2014
Last Update Date	:	06/20/2014

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Directions to “ DOUG HAAR ” Practice Location

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