Healthcare Provider Details

I. General information

NPI: 1245890888
Provider Name (Legal Business Name): HIRA HAYEE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 W SAGINAW RD
SANFORD MI
48657-9206
US

IV. Provider business mailing address

4000 WELLNESS CHRISTIE BLDG
MIDLAND MI
48670-2000
US

V. Phone/Fax

Practice location:
  • Phone: 989-687-9940
  • Fax:
Mailing address:
  • Phone: 989-839-3500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351045132
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4351045132
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: