Haller, David Lee

Haller, David Lee is an individual health care provider with primary practice located at 420 E Division St , Fond Du Lac WI 54935-4560. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Haller, David Lee can be contacted via phone (920) 926-8570.

Contact Information

Primary practice address
420 E Division St Fond Du Lac WI 54935-4560
Phone: (920) 926-8570
Fax: (920) 926-8923
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 43137-020 Wisconsin

Profile Details

NPI number 1548214463
LBN Legal business name Haller, David Lee
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2006
Last updated Dec 2nd, 2020 - about 5 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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Identifiers

StateTypeNumberIssuer
All States NPI 1548214463 NPPES
Wisconsin MEDICAID 34061900

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