Individual
JACOB CARL HAGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 325-1000
Mailing address
7934 N SHORE CT, GRAWN, MI 49637-9581
(248) 534-2819
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101028922
MI
207P00000X
Emergency Medicine Physician
V9616
TX
Other
Enumeration date
05/09/2022
Last updated
05/04/2026
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