Individual
MARY REBECCA HAAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1111 RONALD REAGAN PKWY STE C1400, AVON, IN 46123-7085
(317) 217-2777
(317) 217-2775
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01032115
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
01032115A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100133690A
—
IN
Enumeration date
07/05/2006
Last updated
09/01/2022
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