MEDICARE: AMY HAYES

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
1	261QS1000X	Student Health Clinic/Center	Q-10001342	DE

General Provider Information

NPI Number	:	1811383219
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HAYES

Provider Business Mailing Address
First Line	:	22472 WATERVIEW RD
Second Line	:
City	:	LEWES
State	:	DE
Zip	:	19958-5714
Country	:	US
Telephone Number	:	302-381-8058
Fax Number	:

Provider Business Practice Location Address
First Line	:	29772 ARMORY RD
Second Line	:
City	:	DAGSBORO
State	:	DE
Zip	:	19939-4354
Country	:	US
Telephone Number	:	302-732-3680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2015
Last Update Date	:	04/13/2015

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