Paul Walter Haduck, DO
Individual provider Active NPI Family Medicine Physician · Munising, MI
NPI 1679587174 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1679587174
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 5101010351 (MI)
- Practice address
- 1500 Sandpoint Rd
Munising, MI 49862-1406 - Phone
- (906) 387-4338
- Fax
- (906) 387-2825
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Michigan State University College of Human Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Munising Memorial Hospital Association
Practice addresses (Care Compare)
1500 Sandpoint Rd
Munising, MI 49862-1406
Phone (906) 387-4110
Hospital & facility affiliations
- North Woods Home Nursing
- Munising Memorial Hospital
- Schoolcraft Memorial Hospital
- Uphs Marquette DLP Hospital
- Medilodge of Munising
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121221000159 | MI | Practitioner - Family Practice |
0042393142 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5101010351 | MI | MD | Family Medicine Physician |
| PH5101010351 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Opdyke Family Medical, P.C. | Family Medicine | Current | Accepting new patients |
| Munising Memorial Hospital Association | Family Medicine | Current |
Accepting new patients |
| Opdyke Medical, PLLC | Current | Accepting new patients | |
| Munising Memorial Hospital Association | Family Medicine | Current |
Accepting new patients |
| Munising Memorial Hospital Association | Current | Accepting new patients | |
| Munising Opco, LLC | Past | Accepting new patients | |
| SJMH Medical Practice-SMHC | Past | Accepting new patients |
Locations
719 S Opdyke Rd
Auburn Hills, MI 48326
Phone (248) 333-2600
1514 Sandpoint Rd
Munising, MI 49862
Phone (906) 387-4110
1500 Sandpoint Rd
Munising, MI 49862
Phone (906) 387-4110
Interoperability endpoints
- https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10065479
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | PH5101010351 | MI | |
| Family Medicine Physician | 207Q00000X | 5101010351 | MI | Yes |
Addresses
Primary practice location
1500 Sandpoint Rd
Munising, MI 49862-1406
Mailing address
1500 Sandpoint Rd
Munising, MI 49862-1406
Phone (906) 387-4338
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2805340 | Medicaid | MI |
Other providers in Munising, MI
- FMG West City Park Drive Michigan LLC
- Karen Sue Freeborn
- Cassandra Gasman
- Marissa Emily Graves
- Great Lakes Recovery Centers
- Rachel M Harmon
- Healthquest of Alger County PLC
- Hiawatha Medical PC
- Colin Irish
- Jmsii Chiropractic PC
All providers in Munising, MI · Family Medicine Physician in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.