Healthcare Provider Details

I. General information

NPI: 1720210826
Provider Name (Legal Business Name): KAYOKO HAYAKAWA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2009
Last Update Date: 08/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3990 JOHN R ST HARPER HOSPITAL, RM5910, 5 HUDSON
DETROIT MI
48201-2018
US

IV. Provider business mailing address

4201 SAINT ANTOINE ST 9C-UHC, DETROIT MEDICAL CENTER
DETROIT MI
48201-2153
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-9649
  • Fax:
Mailing address:
  • Phone: 313-745-5146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number4301093742
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: