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Individual

DR. SAM HAKKI HACKETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
27789 MOUND RD STE 100, WARREN, MI 48092-2697
(313) 209-3353
(313) 406-7255
Mailing address
PO BOX 880, STERLING HTS, MI 48311-0880

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
4301104354
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MI7592002
MEDICARE IDENTIFICATION NUMBER
MI
Enumeration date
06/13/2006
Last updated
04/30/2021
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