Healthcare Provider Details

I. General information

NPI: 1558675009
Provider Name (Legal Business Name): MICHAEL G. HAYES, M.D.PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 LINDEN AVE
BALTIMORE MD
21201-4606
US

IV. Provider business mailing address

2402 HEMLOCK AVE
BALTIMORE MD
21214-1517
US

V. Phone/Fax

Practice location:
  • Phone: 410-225-8240
  • Fax:
Mailing address:
  • Phone: 410-426-1805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberD0002290
License Number StateMD

VIII. Authorized Official

Name: MICHAEL GILBERT HAYES
Title or Position: MEDICAL DIRECTOR/CEO
Credential: M.D. PA
Phone: 410-225-8240