Individual
KURT A HALLER
Active
Individual
KURT A HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301407101
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0830591
IBA/PHP
MI
01
—
119351
GREAT LAKES HEALTH PLAN
MI
01
—
135840000
DEPARTMENT OF LABOR
MI
01
—
180035058
RAILROAD MEDICARE
MI
01
—
180C911240
BCBSM
MI
05
—
3373034
—
MI
01
—
383309299006
TRICARE
MI
01
—
3833092991335
COMMUNITY CHOICE
MI
01
—
4302174
AETNA
MI
Enumeration date
05/06/2006
Last updated
05/19/2008
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