MEDICARE: JOSEPH HOWARD HASLITT MD

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	207RN0300X	Nephrology Physician	01030816	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000084788	OTHER		BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134112113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH HOWARD HASLITT MD

Provider Business Mailing Address
First Line	:	2701 W NORTH ST
Second Line	:	SUITE B
City	:	MUNCIE
State	:	IN
Zip	:	47303-3415
Country	:	US
Telephone Number	:	765-287-0248
Fax Number	:	765-287-0265

Provider Business Practice Location Address
First Line	:	2701 W NORTH ST
Second Line	:	SUITE B
City	:	MUNCIE
State	:	IN
Zip	:	47303-3415
Country	:	US
Telephone Number	:	765-287-0248
Fax Number	:	765-287-0265

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

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	04/17/2008

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