Individual
DR. MATTHEW RYAN HAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(678) 493-2527
(678) 493-5608
Mailing address
460 NORTHSIDE CHEROKEE BLVD STE 130, CANTON, GA 30115-8017
(678) 493-2527
(678) 493-5608
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5643
NE
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
070192
GA
207RP1001X
Pulmonary Disease Physician
Primary
070192
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003137391A
—
GA
Enumeration date
10/16/2007
Last updated
04/26/2021
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