Healthcare Provider Details

I. General information

NPI: 1598053647
Provider Name (Legal Business Name): CYNTHIA ABOU MAYLA HAYEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 04/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 N. KANSAS WCGME
WICHITA KS
67214
US

IV. Provider business mailing address

1010 N. KANSAS WCGME
WICHITA KS
67214
US

V. Phone/Fax

Practice location:
  • Phone: 316-962-3030
  • Fax:
Mailing address:
  • Phone: 316-962-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number04-40580
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number7585
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: