MEDICARE: MAUREEN HAUCK AA

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	207L00000X	Anesthesiology Physician	AA-824	AL

General Provider Information

NPI Number	:	1770579864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN HAUCK AA

Provider Business Mailing Address
First Line	:	4556 GRAYWOOD TRCE
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30092-1026
Country	:	US
Telephone Number	:	404-437-6880
Fax Number	:

Provider Business Practice Location Address
First Line	:	4575 N SHALLOWFORD RD
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30338-6445
Country	:	US
Telephone Number	:	770-454-4065
Fax Number	:	770-454-4065

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/08/2007

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Directions to “ MAUREEN HAUCK AA” Practice Location

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