Healthcare Provider Details

I. General information

NPI: 1689852469
Provider Name (Legal Business Name): TAMARA LYNETTE HAYES M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAMARA LYNETTE WATSON M.D.

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 BOYDS COVE CT
ANNAPOLIS MD
21401-7315
US

IV. Provider business mailing address

204 BOYDS COVE CT
ANNAPOLIS MD
21401-7315
US

V. Phone/Fax

Practice location:
  • Phone: 410-841-0040
  • Fax:
Mailing address:
  • Phone: 410-841-0040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberD0067030
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: