Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 4301086622 | MI |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 1008 | WV |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD448855 | PA |
NPI | 1285757781 |
---|---|
Provider Name | Jeremiah William Hayanga |
First Address | Morgantown, WV 26506-1200 |
Second Address | Morgantown, WV 26506-1200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2007 |
Last Update Date | 17/03/2018 |