Healthcare Provider Details

I. General information

NPI: 1740806884
Provider Name (Legal Business Name): CHRISTOPHER COLLIN HAYES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2020
Last Update Date: 06/24/2020
Certification Date: 06/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CHILDRENS HOSPITAL OUTPATIENT CENTER 14 MEDICAL PARK, STE 400
COLUMBIA SC
29203
US

IV. Provider business mailing address

CHILDRENS HOSPITAL OUTPATIENT CENTER 14 MEDICAL PARK, STE 400
COLUMBIA SC
29203
US

V. Phone/Fax

Practice location:
  • Phone: 803-434-6155
  • Fax: 803-434-6979
Mailing address:
  • Phone: 803-434-6155
  • Fax: 803-434-6979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL83247
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: