Healthcare Provider Details

I. General information

NPI: 1730428103
Provider Name (Legal Business Name): MARTHA MCCREE HAYES RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/05/2013
Last Update Date: 02/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 SPRINGCREST DR
COLUMBIA SC
29223-6100
US

IV. Provider business mailing address

7500 SPRINGCREST DR
COLUMBIA SC
29223-6100
US

V. Phone/Fax

Practice location:
  • Phone: 803-736-8754
  • Fax: 803-736-8773
Mailing address:
  • Phone: 803-736-8754
  • Fax: 803-736-8773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberR 105527
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: