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NPI Code Detail

MEDICARE: KAMERON MCKENZIE HAAKE MD

MEDICARE: KAMERON MCKENZIE HAAKE MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician86859WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1871346601
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAMERON MCKENZIE HAAKE MD
Provider Business Mailing Address
First Line : 1100 DELAPLAINE CT
Second Line :
City : MADISON
State : WI
Zip : 53715-1840
Country : US
Telephone Number : 608-263-4550
Fax Number :
Provider Business Practice Location Address
First Line : 1102 S PARK ST
Second Line :
City : MADISON
State : WI
Zip : 53715-1708
Country : US
Telephone Number : 608-263-3111
Fax Number : 608-263-6663
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2024
Last Update Date : 05/04/2026

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Directions to “ KAMERON MCKENZIE HAAKE MD” Practice Location

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