Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | MD048180 | DC |
NPI | 1194253518 |
---|---|
Provider Name | Dr. Harrison James Hayward |
First Address | Atlanta, GA 30374-4785 |
Second Address | Washington, DC 20010-2916 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2017 |
Last Update Date | 17/06/2020 |