MEDICARE: CRAIG S HAYEK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101056480	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	261083931	OTHER	VA	TAX ID

General Provider Information

NPI Number	:	1720053358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRAIG S HAYEK MD

Provider Business Mailing Address
First Line	:	134 ELON RD
Second Line	:
City	:	MADISON HEIGHTS
State	:	VA
Zip	:	24572-2536
Country	:	US
Telephone Number	:	434-455-2480
Fax Number	:	434-455-2487

Provider Business Practice Location Address
First Line	:	582 BLUE RIDGE AVE
Second Line	:
City	:	BEDFORD
State	:	VA
Zip	:	24523-2604
Country	:	US
Telephone Number	:	434-929-1400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	09/08/2020

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