Provider Demographics
NPI:1447296124
Name:DE HAAS, ANTHONY HUUB (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:HUUB
Last Name:DE HAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:14490 OCEAN HWY
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-9998
Mailing Address - Country:US
Mailing Address - Phone:843-545-8850
Mailing Address - Fax:843-545-5081
Practice Address - Street 1:14490 OCEAN HWY
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-9998
Practice Address - Country:US
Practice Address - Phone:843-545-8850
Practice Address - Fax:843-545-5081
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC20905208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCT49276Medicaid
SCT49276Medicaid
SCG923606593Medicare ID - Type Unspecified