Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | D0002290 | MD |
NPI | 1871566125 |
---|---|
Provider Name | Dr. Michael Hayes |
First Address | Baltimore, MD 21214-1517 |
Second Address | Baltimore, MD 21201-4606 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 20/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
28440280 | (05) | MD |
D74621 | (02) |