Healthcare Provider Details

I. General information

NPI: 1255426060
Provider Name (Legal Business Name): MICHELE T HAYWOOD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 10/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 E WATERLOO RD STE 313
AKRON OH
44312-3814
US

IV. Provider business mailing address

2215 E WATERLOO RD STE 313
AKRON OH
44312-3814
US

V. Phone/Fax

Practice location:
  • Phone: 330-208-2720
  • Fax: 330-208-2721
Mailing address:
  • Phone: 330-208-2720
  • Fax: 330-208-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number35074760
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: