Individual
PHILIP C. HAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1011 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-3664
(616) 957-2200
(616) 957-4274
Mailing address
1011 PARCHMENT DR SE, GRAND RAPIDS, MI 49546-3664
(616) 957-2200
(616) 957-4274
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
4301033971
MI
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
4301033971
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103028918
—
MI
01
—
383145416
TAX I.D. NUMBER
—
Enumeration date
12/08/2006
Last updated
07/11/2011
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