Haderlie, Michael John
Haderlie, Michael John is an individual health care provider with primary practice located at 4511 Zebe Ave , Chubbuck ID 83202-4707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Haderlie, Michael John can be contacted via phone (208) 904-4780.Contact Information
Primary practice address
4511 Zebe Ave
Chubbuck ID 83202-4707
Phone: (208) 904-4780
Fax: (208) 904-4832
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | M-10858 | Idaho |
Profile Details
| NPI number | 1700083813 |
|---|---|
| LBN Legal business name | Haderlie, Michael John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 2nd, 2007 |
| Last updated | Dec 8th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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