Individual
DR. ROGER B HAAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
107 N LAFAYETTE ST, SOUTH LYON, MI 48178-1210
(248) 437-2002
(248) 437-6838
Mailing address
107 N LAFAYETTE ST, SOUTH LYON, MI 48178-1210
(248) 437-2002
(248) 437-6838
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002500
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0421320001
MED-B-DME
MI
05
—
1754793
—
MI
01
—
813459
EYEMED VISION CARE
MI
01
—
900F367430
BLUE CROSS BLUE SHIELD
MI
01
—
VC630013
M-CARE VISION
MI
Enumeration date
12/04/2006
Last updated
07/08/2007
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