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Individual

DR. GWEN H HAAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
29804 LAKESHORE BLVD, WILLOWICK, OH 44095
(440) 833-2095
(440) 833-2096
Mailing address
PO BOX 714328, COLUMBUS, OH 43271-4328
(440) 833-2095
(440) 833-2096

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35058311
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
857390
OH
Enumeration date
08/21/2006
Last updated
02/26/2021
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