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General NPI Number Information
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NPI Number | 1891095220
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Entity Type | Organization
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Legal Business Name | EDWARD E. HAYES M.D.LLC
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Dates
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Enumeration Date | 11/02/2010
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Last Update Date | 11/02/2010
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Provider Practice Location Address
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Address Line | 12 MEDICAL CENTER DR
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City | SUPPLY
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State | NC
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Zip | 28462-3350
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Country | US
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Telephone | 910-755-6620
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Fax | 910-755-6632
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Provider Business Mailing Address
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Address Line | 12 MEDICAL CENTER DR
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City | SUPPLY
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State | NC
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Zip | 28462-3350
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Country | US
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Telephone | 910-755-6620
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Fax | 910-755-6632
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD ELEM HAYES
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Credential | M.D.
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Telephone | 910-755-6620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 33528
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License Number State | NC
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