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NPI Code Detail

MEDICARE: DR. KIRK CHARLES HAIDET M.D.

MEDICARE: DR. KIRK CHARLES HAIDET 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
1207X00000XOrthopaedic Surgery Physician35.131762OH
2207XS0106XOrthopaedic Hand Surgery Physician35.131762OH

General Provider Information

NPI Number : 1427344209
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIRK CHARLES HAIDET M.D.
Provider Business Mailing Address
First Line : 5800 COOPER FOSTER PARK RD W
Second Line :
City : LORAIN
State : OH
Zip : 44053-4131
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5800 COOPER FOSTER PARK RD W
Second Line :
City : LORAIN
State : OH
Zip : 44053-4131
Country : US
Telephone Number : 440-204-7800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2011
Last Update Date : 05/28/2024

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