Individual
DR. MARY ARNDT HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
58575
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12805
DEAN
WI
05
—
34051400
—
WI
01
—
39080723696
BLUE CROSS BLUE SHIELD
WI
01
—
501782
TOUCHPOINT
WI
01
—
WI01P1
JOHN DEERE
WI
Enumeration date
11/03/2005
Last updated
03/09/2015
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