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NPI Code Detail

MEDICARE: MARION C HAUTEA M.D.

MEDICARE: MARION C HAUTEA 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
1207Q00000XFamily Medicine PhysicianMH069111MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
30F06016OTHERMIMEDICARE BILL PAY TO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962455972
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARION C HAUTEA M.D.
Provider Business Mailing Address
First Line : PO BOX 427
Second Line :
City : HILLMAN
State : MI
Zip : 49746-0427
Country : US
Telephone Number : 989-742-4583
Fax Number : 989-742-4298
Provider Business Practice Location Address
First Line : 205 S BRADLEY HWY
Second Line :
City : ROGERS CITY
State : MI
Zip : 49779-2137
Country : US
Telephone Number : 989-734-2052
Fax Number : 989-734-7390
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 09/09/2021

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Directions to “ MARION C HAUTEA M.D.” Practice Location

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