MEDICARE: DR. MICHAEL C HAUPT M.D.

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	207P00000X	Emergency Medicine Physician	ME49906	FL
2	208D00000X	General Practice Physician	ME49906	FL
3	207R00000X	Internal Medicine Physician	ME49906	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	04476X	OTHER	FL	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	231025	OTHER	FL	AMERIGROUP
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	2567719	OTHER	FL	CIGNA
5	930074798	OTHER	FL	RAILROAD
6	4235619	OTHER	FL	AETNA
7	04467	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1245274927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL C HAUPT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1357
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-1357
Country	:	US
Telephone Number	:	239-278-3600
Fax Number	:	239-278-3203

Provider Business Practice Location Address
First Line	:	708 DEL PRADO BLVD
Second Line	:	SUITE 9
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-5616
Country	:	US
Telephone Number	:	239-574-2644
Fax Number	:	239-574-1451

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

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	07/08/2009

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Directions to “ DR. MICHAEL C HAUPT M.D.” Practice Location

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