MEDICARE: DR. STEVEN G. HAUPT PH.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	103TC0700X	Clinical Psychologist	6301008076	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	041733	OTHER	MI	VALUE OPTIONS
2	0987029	OTHER	MI	HEALTH PLUS

General Provider Information

NPI Number	:	1508827643
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN G. HAUPT PH.D.

Provider Business Mailing Address
First Line	:	2098 MITCHELL ST
Second Line	:
City	:	SAGINAW
State	:	MI
Zip	:	48603-3645
Country	:	US
Telephone Number	:	989-799-8498
Fax Number	:

Provider Business Practice Location Address
First Line	:	4901 TOWNE CTR
Second Line	:	SUITE 115
City	:	SAGINAW
State	:	MI
Zip	:	48604-2841
Country	:	US
Telephone Number	:	989-921-5715
Fax Number	:	989-921-5960

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

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	07/08/2007

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