Individual
DR. DOUGLAS L HAAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
30 S MAIN ST, DOLGEVILLE, NY 13329-1318
(315) 429-8065
(315) 429-3195
Mailing address
30 S MAIN ST, DOLGEVILLE, NY 13329-1318
(315) 429-8065
(315) 429-3195
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
174706-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01108236
—
NY
01
—
040403006407
FIDELIS
NY
01
—
085224
MOHAWK VALLEY PHYSICANS
NY
01
—
16-1339507
TAX ID #
NY
01
—
174706-1
STATE LICENSE NUMBER
NY
Enumeration date
09/26/2006
Last updated
12/22/2009
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