Healthcare Provider Details

I. General information

NPI: 1962482828
Provider Name (Legal Business Name): SHARON R HAYWARD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W ICE LAKE RD
IRON RIVER MI
49935-9526
US

IV. Provider business mailing address

N1246 COUNTY ROAD H
STANLEY WI
54768-9618
US

V. Phone/Fax

Practice location:
  • Phone: 906-308-0230
  • Fax:
Mailing address:
  • Phone: 715-644-8168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number39964
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: