Organization Name: | HAYES MEDICAL CENTER PA |
NPI Number: | 1316021819 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ANGELA M HAYES (OFFICE MANAGER) |
Mailing Address: | 5205 Gwynn Oak Ave 1st Fl Baltimore |
State: | MO US |
Postal Code: | 21207 |
Phone Number: | 4104489785 |
Fax Number: | 4104484755 |
NPI Enumeration Date: | 10/24/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |