Individual provider · Type 1 NPI

Kelly Jeane Haidar, DO

Student in an Organized Health Care Education/Training Program · Canton, MI

NPI number 1508557968 Active

Practice location

1051 N Canton Center Rd
Canton, MI 48187-5097

Call (734) 539-5080 Map

Mailing address

1522 Simpson Dr, Mpb D3230
Ann Arbor, MI 48109

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X5151016046 (MI)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1508557968

Kelly Jeane Haidar, DO's National Provider Identifier is 1508557968, issued on May 17, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Canton, MI. The record was last updated on May 17, 2023.