MEDICARE: DR. DONALD HASWELL 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	2085R0202X	Diagnostic Radiology Physician	114034	NY
2	2085R0204X	Vascular & Interventional Radiology Physician	114034	NY

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730171711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD HASWELL M.D.

Provider Business Mailing Address
First Line	:	4567 CROSSROADS PARK DR
Second Line	:	2ND FLOOR
City	:	LIVERPOOL
State	:	NY
Zip	:	13088-3589
Country	:	US
Telephone Number	:	315-295-2100
Fax Number	:	315-295-2125

Provider Business Practice Location Address
First Line	:	301 PROSPECT AVE
Second Line	:
City	:	SYRACUSE
State	:	NY
Zip	:	13203-1807
Country	:	US
Telephone Number	:	315-448-5274
Fax Number	:

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

Provider Enumeration Date	:	08/17/2005
Last Update Date	:	09/13/2007

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