Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | POD1002 | ME |
Y | 222Z00000X | Podiatrist | POD1002 | ME |
N | 213EP1101X | Primary Podiatric Medicine | POD1002 | ME |
NPI | 1467547158 |
---|---|
Provider Name | Ernest M. Hayes, Dpm |
First Address | Lubec, ME 04652-0538 |
Second Address | Machias, ME 04654-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 31/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
017292 | ANTHEM BLUE CROSS BLUE SHIELD (01) | ME |
T11015 | (02) | ME |