Individual
MICHAEL HAVENER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA
Contact information
Practice address
1761 BEALL AVE, WOOSTER, OH 44691-2342
(330) 263-8100
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67000013
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2277414
—
OH
Enumeration date
06/26/2006
Last updated
06/22/2010
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