Individual
JERRY L. HAAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
350 FRONT ST, ELMER, NJ 08318-2143
(856) 358-8113
(856) 358-1305
Mailing address
350 FRONT ST, ELMER, NJ 08318-2143
(856) 358-8113
(856) 358-1305
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA02782500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2196409
—
NJ
Enumeration date
06/11/2006
Last updated
11/19/2009
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