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NPI Code Detail

MEDICARE: DR. SHELANDA CHARISE HAYES MD

MEDICARE:  DR. SHELANDA CHARISE HAYES  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174H00000XHealth Educator
2207Q00000XFamily Medicine Physician036-108398IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528194131
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHELANDA CHARISE HAYES MD
Provider Business Mailing Address
First Line : 13229 TRADITION DR
Second Line :
City : DADE CITY
State : FL
Zip : 33525-6219
Country : US
Telephone Number : 708-799-9700
Fax Number : 708-799-9701
Provider Business Practice Location Address
First Line : 19740 GOVERNORS HWY
Second Line : STE 116
City : FLOSSMOOR
State : IL
Zip : 60422-2085
Country : US
Telephone Number : 708-799-9700
Fax Number : 708-799-9701
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 11/20/2020

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Directions to “ DR. SHELANDA CHARISE HAYES MD” Practice Location

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