MEDICARE: KRIS A HAASE DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	KH001672	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	480033238	OTHER	MI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7599462	OTHER	MI	AETNA
2	C8124	OTHER	MI	M CARE
3	KH001672	OTHER	MI	MICHIGAN LICENSE
5	4856359200	OTHER	MI	BLUE CROSS AND BLUE SHIEL

General Provider Information

NPI Number	:	1912906751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRIS A HAASE DPM

Provider Business Mailing Address
First Line	:	7116 HIGHLAND RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48327-1503
Country	:	US
Telephone Number	:	248-666-8807
Fax Number	:	248-666-7709

Provider Business Practice Location Address
First Line	:	7116 HIGHLAND RD
Second Line	:
City	:	WATERFORD
State	:	MI
Zip	:	48327-1503
Country	:	US
Telephone Number	:	248-666-8807
Fax Number	:	248-666-7709

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

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	04/19/2013

Similar Medicare Providers

1922054220 — KRIS A HAASE DPM PLC
Practice Location Address:

7116 HIGHLAND RD
WATERFORD, MI
48327-1503

Practice Phone: 248-666-8807
Practice Fax: 248-666-7709

1073650206 — KRIS A HAASE DPM PLC
Practice Location Address:

7611 HIGHLAND RD
WATERFORD, MI
48327-1503

Practice Phone: 248-666-8807
Practice Fax: 248-666-7709

1972732055 — DR. LUCCIA HOLMES-BERNSTEIN D.P.M.
Practice Location Address:

7116 HIGHLAND RD
WATERFORD, MI
48327-1503

Practice Phone: 248-666-8807
Practice Fax: 248-666-7709

1588103865 — DR. BLERTA LICI GAQI DO
Practice Location Address:

7112 HIGHLAND RD
WATERFORD, MI
48327-1503

Practice Phone: 248-509-0055
Practice Fax:

1265014302 — MADISON RAE MARTIN RN, MSN
Practice Location Address:

7124 HIGHLAND RD
WATERFORD, MI
48327-1503

Practice Phone: 248-431-7245
Practice Fax:

1497497903 — DR. ZACKARY JOSEPH CLOR DPM
Practice Location Address:

7116 HIGHLAND RD
WATERFORD, MI
48327-1503

Practice Phone: 248-666-8807
Practice Fax: 248-666-7709

Directions to “ KRIS A HAASE DPM” Practice Location

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