Individual
KURT A HALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1052 GULL RD, KALAMAZOO, MI 49048-1734
(269) 343-1684
(269) 343-5375
Mailing address
1052 GULL RD, KALAMAZOO, MI 49048-1734
(269) 343-1684
(269) 343-5375
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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